Evaluating the Correlation between PD-L1 Antibody Radiotracers and PD-1/PD-L1 Expression in Non-Small-Cell Lung Cancer: A Meta-Analysis
DOI:
https://doi.org/10.71222/czsmm264Keywords:
PD-L1, PD-1, non-small-cell lung cancer (NSCLC), antibody radiotracers, PET/CT, SPECT/CT, tumor heterogeneity, SUVmax, T:BP ratio, immune checkpoint inhibitors, precision oncologyAbstract
Non-small-cell lung cancer (NSCLC) accounts for the majority of lung cancer cases, with PD-1/PD-L1 immune checkpoint inhibitors playing a crucial role in treatment. Accurate assessment of PD-L1 expression is essential for patient stratification, yet traditional biopsies are limited by tumor heterogeneity. This meta-analysis evaluates the correlation between PD-L1 antibody radiotracers and PD-1/PD-L1 expression in NSCLC patients using PET/CT and SPECT/CT imaging. Analysis of four clinical trials involving 50 patients and six NSCLC samples revealed that higher SUVmax and T:BP ratios correlated with PD-L1 expression and prognosis, offering a more comprehensive and non-invasive alternative to biopsies. While promising, standardization of imaging parameters and further validation in diverse patient populations are needed to refine clinical application.
References
1. A. Friedlaender et al., "Targeted therapies in early stage NSCLC: hype or hope?," Int. J. Mol. Sci., vol. 21, no. 17, 2020, doi: 10.3390/ijms21176329.
2. J. F. P. Bridges et al., "Patients' preferences for treatment outcomes for advanced non-small cell lung cancer: a conjoint analysis," Lung Cancer, vol. 77, no. 1, pp. 224-231, 2012, doi: 10.1016/j.lungcan.2012.01.016.
3. K. Masuda et al., "Efficacy of anti-PD-1 antibodies in NSCLC patients with an EGFR mutation and high PD-L1 expression," J. Cancer Res. Clin. Oncol., vol. 147, no. 1, pp. 245-251, 2020, doi: 10.1007/s00432-020-03329-0.
4. J. He et al., "Development of PD-1/PD-L1 pathway in tumor immune microenvironment and treatment for non-small cell lung cancer," Sci. Rep., vol. 5, no. 1, p. 13110, 2015, doi: 10.1038/srep13110.
5. R. Brody et al., "PD-L1 expression in advanced NSCLC: Insights into risk stratification and treatment selection from a sys-tematic literature review," Lung Cancer, vol. 112, pp. 200-215, 2017, doi: 10.1016/j.lungcan.2017.08.005.
6. J. Czernin and M. E. Phelps, "Positron emission tomography scanning: current and future applications," Annu. Rev. Med., vol. 53, no. 1, pp. 89-112, 2002, doi: 10.1146/annurev.med.53.082901.104028.
7. Y. Xing et al., "Early phase I study of a 99mTc-labeled anti–programmed death ligand-1 (PD-L1) single-domain antibody in SPECT/CT assessment of PD-L1 expression in non–small cell lung cancer," J. Nucl. Med., vol. 60, no. 9, pp. 1213-1220, 2019, doi: 10.2967/jnumed.118.224170.
8. M. A. Khan et al., "Positron emission tomography scanning in the evaluation of hepatocellular carcinoma," J. Hepatol., vol. 32, no. 5, pp. 792-797, 2000, doi: 10.1016/S0168-8278(00)80248-2.
9. K. Vekens et al., "The value of 18F-FDG PET/CT in predicting the response to PD-1 blocking immunotherapy in advanced NSCLC patients with high-level PD-L1 expression," Clin. Lung Cancer, vol. 22, no. 5, pp. 432-440, 2021, doi: 10.1016/j.cllc.2021.03.001.
10. A.-L. N. Niemeijer et al., "First-in-human study of 89Zr-pembrolizumab PET/CT in patients with advanced stage non-small-cell lung cancer," J. Nucl. Med., Jul. 1, 2021, doi: 10.2967/jnumed.121.261926.
11. L. Monaco, E. De Bernardi, F. Bono, et al., "The 'digital biopsy' in non-small cell lung cancer (NSCLC): a pilot study to predict the PD-L1 status from radiomics features of [18F] FDG PET/CT," Eur. J. Nucl. Med. Mol. Imaging, vol. 49, pp. 3401-3411, 2022, doi: 10.1007/s00259-022-05783-z.
12. F. Bensch et al., "89ZR-atezolizumab imaging as a non-invasive approach to assess clinical response to PD-L1 blockade in cancer," Nat. Med., vol. 24, no. 12, pp. 1852-1858, 2018, doi: 10.1038/s41591-018-0255-8.
13. Y. Xing et al., "Early phase I study of a 99mTc-labeled anti-programmed death ligand-1 (PD-L1) single-domain antibody in SPECT/CT assessment of PD-L1 expression in non-small cell lung cancer," J. Nucl. Med., vol. 60, no. 9, pp. 1213-1220, 2019, doi: 10.2967/jnumed.118.224170.
14. A.-L. N. Niemeijer et al., "Whole body PD-1 and PD-L1 positron emission tomography in patients with non-small-cell lung cancer," Nat. Commun., vol. 9, no. 1, 2018, doi: 10.1038/s41467-018-07131-y.
15. L. Wu et al., "Negative correlation between 18F-RGD uptake via PET and tumoral PD-L1 expression in non-small cell lung cancer," Front. Endocrinol., vol. 13, 2022, doi: 10.3389/fendo.2022.913631.
16. A.-L. N. Niemeijer et al., "Study of 89Zr-pembrolizumab PET/CT in patients with advanced-stage non-small cell lung cancer," J. Nucl. Med., vol. 63, no. 3, pp. 362-367, 2021, doi: 10.2967/jnumed.121.261926.
17. M. Jiang et al., "Assessing PD-L1 expression level by radiomic features from PET/CT in non small cell lung cancer patients: An initial result," Acad. Radiol., vol. 27, no. 2, pp. 171-179, May 27, 2019, doi: 10.1016/j.acra.2019.04.016.
18. H. Ba et al., "The relationship between blood-based tumor mutation burden level and efficacy of PD-1/PD-L1 inhibitors in advanced non-small cell lung cancer: A systematic review and meta-analysis," BMC Cancer, vol. 21, no. 1, 2021, doi: 10.1186/s12885-021-08924-z.
