Optimizing the tumor shrinkage threshold for evaluating immunotherapy efficacy for advanced non-small-cell lung cancer

J Cancer Res Clin Oncol. 2023 Mar;149(3):1103-1113. doi: 10.1007/s00432-022-03978-3. Epub 2022 Mar 18.

Abstract

Purpose: The rise of immune checkpoint inhibitors (ICIs) in recent years has coincided with unusual clinical response patterns. Modification of the sum of longest diameters (SLD)-based threshold that reflecting dynamic change of the tumor burden and predicting response to ICIs, may markedly improve current treatment regimens.

Methods: The baseline and post-treatment SLD of target lesion was recorded and the maximum percent change of the SLD from baseline was designated as SLD-change score. The optimal cut-off value was obtained using the X-tile program. The relationship between SLD-change score and survival outcome (PFS, OS) was evaluated.

Results: 10% cut-off value of SLD-change score was found to be most distinctive for PFS. Responders defined according to this cut-off value showed a significant improvement for PFS and OS. Bone metastasis and brain metastasis were also two independent prognostic factors of PFS and OS, respectively.

Conclusions: 10% SLD change score could discriminate for ICIs treatment response, which holds great promise in promoting the development of precise immunotherapeutic strategy.

Keywords: Check point inhibitors; Immunotherapy; Non-small cell lung cancer; RECIST; SLD.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Humans
  • Immunotherapy
  • Lung Neoplasms* / pathology
  • Treatment Outcome