Radiolabelled anti-PD-L1 peptide PET/CT in predicting the efficacy of neoadjuvant immunotherapy combined with chemotherapy in resectable non-small cell lung cancer

Xin Zhou; Shi Yan; Dan Li; Hua Zhu; Bing Liu; Shiwei Liu; Wei Zhao; Zhi Yang; Nan Wu; Nan Li

doi:10.1007/s12149-024-02009-0

Radiolabelled anti-PD-L1 peptide PET/CT in predicting the efficacy of neoadjuvant immunotherapy combined with chemotherapy in resectable non-small cell lung cancer

Ann Nucl Med. 2024 Dec 14. doi: 10.1007/s12149-024-02009-0. Online ahead of print.

Authors

Xin Zhou^#¹, Shi Yan^#², Dan Li¹, Hua Zhu¹, Bing Liu², Shiwei Liu¹, Wei Zhao¹, Zhi Yang³, Nan Wu⁴, Nan Li⁵

Affiliations

¹ State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China.
² Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China.
³ State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China. pekyz@163.com.
⁴ Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China. nanwu@bjmu.edu.cn.
⁵ State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China. rainbow6283@sina.com.

^# Contributed equally.

PMID: 39673015
DOI: 10.1007/s12149-024-02009-0

Abstract

Background: This study aimed to evaluate the predictive value of baseline PD-L1 targeted peptide ⁶⁸Ga-NOTA-WL12 PET/CT in neoadjuvant immunotherapy combined with chemotherapy of resectable NSCLC.

Methods: Patients with resectable NSCLC (n = 20) enrolled in this prospective study received baseline paired ⁶⁸Ga-NOTA-WL12 PET/CT and ¹⁸F-FDG PET/CT. After 2-4 cycles of toripalimab plus nab-paclitaxel and cisplatin, surgery was performed if R0 resection was available. The major pathologic response (MPR) state of the post-operative specimen was recorded. The imaging parameters of the ⁶⁸Ga-NOTA-WL12 PET/CT, ¹⁸F-FDG PET/CT and CT between the MPR and non-MPR groups and their predictive efficacy of MPR were compared.

Results: Among 20 patients, 17 patients underwent surgery, 10 achieved an MPR and 7 did not. The SUV_max and tumour-to-blood pool (TBR) of baseline ⁶⁸Ga-NOTA-WL12 in the MPR group were higher than those in the non-MPR group, and the difference in TBR was statistically significant. The ΔSUL_peak% of ¹⁸F-FDG exhibited differences between the MPR and non-MPR groups with no significance. Baseline ¹⁸F-FDG PET/CT parameters and ΔD% failed to differentiate the two groups. The areas under the ROC curves of SUV_max, TBR in ⁶⁸Ga-NOTA-WL12 PET/CT, ΔD% and ΔSUL_peak% in ¹⁸F-FDG PET/CT were 0.76, 0.79, 0.71 and 0.80, respectively, in predicting MPR.

Conclusion: Baseline ⁶⁸Ga-NOTA-WL12 PET/CT has a potential to predict the pathological response of neoadjuvant immunotherapy combined with chemotherapy in patients with resectable NSCLC, whose efficacy is comparable to that of therapy evaluations employing baseline and follow-up CT and ¹⁸F-FDG PET/CT examinations.

Trial registration: NCT04304066, registered 13 November 2020, https://register.

Clinicaltrials: gov/prs/app/action/SelectProtocol?sid=S000AEI9&selectaction=Edit&uid=U000503E&ts=2&cx=-awajet .

Keywords: 68Ga-NOTA-WL12; Neoadjuvant immunotherapy; PET/CT; Resectable NSCLC; Toripalimab.

Associated data

ClinicalTrials.gov/NCT04304066

Abstract

Associated data

Grants and funding