PURPOSE Investigate whether 18F-FDG PET-CT has the potential to predict the major pathologic response (MPR) to neoadjuvant sintilimab in resectable NSCLC patients, and the potential of sifting patients who probably benefit from immunotherapy. METHODS Treatment-naive patients with resectable NSCLC (stage IA-IIIB) received two cycles of sintilimab (200 mg, intravenously, day 1 and 22). Surgery was performed between day 29 and 43. PET-CT was obtained at baseline and prior to surgery. The following lean body mass-corrected metabolic parameters were calculated by PET VCAR: SULmax, SULpeak, MTV, TLG, ΔSULmax%, ΔSULpeak%, ΔMTV%, ΔTLG%. PET responses were classified using PERCIST. The above metabolic information on FDG-PET was correlated with the surgical pathology. (Registration Number: ChiCTR-OIC-17013726). RESULTS Thirty-six patients received 2 doses of sintilimab, all of whom underwent PET-CT twice and had radical resection (35) or biopsy (1). MPR occurred in 13 of 36 resected tumors (36.1%, 13/36). The degree of pathological regression was positively correlated with SULmax (p = 0.036) of scan-1, and was negatively correlated with all metabolic parameters of scan-2, and the percentage changes of the metabolic parameters after neoadjuvant therapy (p < 0.05). According to PERCIST, 13 patients (36.1%, 13/36) showed partial metabolic response (PMR), 21 (58.3%, 21/36) had stable metabolic disease, and 2 (5.6%, 2/36) had progressive metabolic disease (PMD). There was a significant correlation between the pathological response and the PET responses which were classified using PERCIST. All (100.0%) the PMR (ΔSULpeak% < - 30.0%) tumors showed MPR. CONCLUSIONS 18F-FDG PET-CT can predict MPR to neoadjuvant sintilimab in resectable non-small cell lung cancer.

中文翻译：

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18F-FDG PET-CT预测可切除的非小细胞肺癌对新辅助PD-1阻滞的主要病理反应的效率。

目的研究18F-FDG PET-CT是否有潜力预测可切除的NSCLC患者对新辅助药物sintilimab的主要病理反应（MPR），以及筛查可能受益于免疫治疗的患者的可能性。方法初治的可切除NSCLC患者（IA-IIIB期）接受了两个周期的sintilimab（200 mg，第1天和第22天静脉注射）。在第29天至第43天之间进行手术。PET-CT在基线和手术前获得。通过PET VCAR计算以下瘦体重校正的代谢参数：SULmax，SULpeak，MTV，TLG，ΔSULmax％，ΔSULpeak％，ΔMTV％，ΔTLG％。PET反应使用PERCIST分类。以上关于FDG-PET的代谢信息与手术病理相关。（注册号：ChiCTR-OIC-17013726）。结果36例患者接受了2剂sintilimab的治疗，所有患者均接受了两次PET-CT手术，并接受了根治性切除术（35）或活检（1）。MPR发生在36例切除的肿瘤中的13例中（36.1％，13/36）。病理消退程度与scan-1的SULmax（p = 0.036）呈正相关，与scan-2的所有代谢参数以及新辅助治疗后代谢参数的百分比变化呈负相关（p <0.05）。根据PERCIST，有13位患者（36.1％，13/36）表现出部分代谢反应（PMR），21位患者（58.3％，21/36）患有稳定的代谢疾病，2位患者（5.6％，2/36）具有进行性代谢疾病（PMD）。病理反应和PET反应之间存在显着相关性，PET反应使用PERCIST进行分类。所有（100.0％）PMR（ΔSULpeak％<-30.0％）肿瘤均显示MPR。