AUTHOR=Ke Linping , Wang Lu , Yu Jinming , Meng Xue 

TITLE=Prognostic Significance of SUVmax Combined With Lactate Dehydrogenase in Advanced Lung Cancer Patients Treated With Immune Checkpoint Inhibitor Plus Chemotherapy: A Retrospective Study

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.652312

DOI=10.3389/fonc.2021.652312

ISSN=2234-943X

ABSTRACT=Purpose  This research aims to investigate the predictive capacity of PET/CT quantitative parameters combined with hematological parameters in advanced lung cancer patients with immune checkpoint inhibitor (ICI) plus Chemotherapy. 
Methods  120 patients who underwent 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) were enrolled before therapy. The following parameters were calculated: the maximum, mean ,peak of standardized uptake value (SUVmax, SUVmean, SUVpeak, respectively), total tumour volume (MTV) and total lesion glycolysis (TLG), and as well as whole-body metabolic value (SUVpeakwb, MTVwb, TLGwb, SUVmeanwb, SUVmaxwb). Lactate dehydrogenase (LDH) levels, absolute neutrophil count, absolute platelet count, albumin levels and derived neutrophil to lymphocyte ratio（dNLR）were also computed. The associations between variables and therapy outcome (evaluated by iRECIST) were analysed.
Results  Based on iRECIST, 32 of 120 patients showed iPD,43 iSD, 36 iPR and 9 iCR. Multivariate analysis founded that the SUVmax, MTVwb, LDH and Absolute platelet count were associated with treatment response (P =0.015, P =0.005,P <0.001 and P =0.015,respectively).Kaplan-Meier survival analyses showed that SUVmax ≥11.42 and LDH ≥245 U/L had shorter OS (P = 0.001 and P = 0.004, respectively). Multivariate cox regression revealed that SUVmax and LDH alone were not correlated with survival prognosis(p=), However, the combination of SUVmax and LDH were independently associated with OS(P=0.015;P=0.001,respectively), Median survival time(MST) for low, intermediate and high group was  24.10 months (95% CI: 19.43 to 28.77), 17.41 months (95% CI: 15.83 to 18.99), and 13.76 months (95% CI: 12.51 to 15.02),respectively.
Conclusion  This study identified SUVmax and LDH correlated with the survival outcome with PD-1/PD-L1 blockade plus Chemotherapy in patients with advanced lung cancer.