68 Ga-granzyme B ( 68 Ga-NOTA-GSI) PET/CT for predicting immunotherapy response and progression free survival in NSCLC.
Ziyi Yang, Zhihuang Hu, Xiaoping Xu et al.
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In 30 seconds
This prospective, single-centre trial evaluated ⁶⁸Ga-NOTA-GSI PET/CT after two treatment cycles in 41 patients with stage IIIB/IV non-small cell lung cancer receiving immunotherapy. Responders had higher SUVmax, SUVmean and tumour-to-background ratio than non-responders. SUVmax independently predicted immune response (OR 15.6, 95% CI 1.419-172.2, P = 0.025) and 2-year progression-free survival (HR 0.398, 95% CI 0.207-0.765, P = 0.006). A nomogram combining SUVmax and tumour stage had an AUC of 0.867 (95% CI 0.750-0.868) for 2-year PFS.
Key findings
- Responders (n = 29) had significantly higher SUVmax, SUVmean and TBR than non-responders (n = 12) (all P < 0.05).
- SUVmax independently predicted immune response (OR 15.6, 95% CI 1.419-172.2, P = 0.025).
- SUVmax AUCs for predicting 1- and 2-year PFS were 0.750 and 0.837, respectively.
- SUVmax independently predicted 2-year PFS (HR 0.398, 95% CI 0.207-0.765, P = 0.006); the SUVmax-and-stage nomogram had an AUC of 0.867 (95% CI 0.750-0.868).
Why it matters
The findings suggest that granzyme B PET/CT measurements may provide an early imaging marker of immune response and subsequent PFS in advanced NSCLC. If validated, this approach could add prognostic information beyond conventional assessment and help inform treatment discussions. The results are preliminary and do not establish that imaging-guided treatment changes improve outcomes.
What to keep in mind
The trial was prospective but single-centre and included 41 patients, limiting the generalisability and precision of its predictive estimates.