Prognostic Value of Bone Marrow Metabolism on Pretreatment 18F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy

Our purpose was to investigate the prognostic value of F-18-FDG PET/CT parameters in melanoma patients before beginning therapy with antibodies to the programmed cell death 1 receptor (anti-PD-1). Methods: Imaging parameters including SUVmax, metabolic tumor volume, and the ratio of bone marrow to liver SUVmean (BLR) were measured from baseline PET/CT in 92 patients before the start of anti PD-1 therapy. The association with survival and imaging parameters combined with clinical factors was evaluated. Clinical and laboratory data were compared between the high-BLR group (<= median) and the low-BLR group (>median). Results: Multivariate analyses demonstrated that BLR was an independent prognostic factor for progression-free and overall survival (P = 0.017 and P = 0.011, respectively). The high-BLR group had higher white blood cell counts and neutrophil counts and a higher level of C-reactive protein than the low-BLR group (P < 0.05). Conclusion: Patients with a high BLR were associated with poor progression-free and overall survival, potentially explained by evidence of systemic inflammation known to be associated with immunosuppression.

Automated summary

The study aimed to investigate the prognostic value of F-18-FDG PET/CT parameters in melanoma patients before starting anti-PD-1 therapy. Results showed that patients with a high BLR were associated with poorer progression-free and overall survival, potentially due to systemic inflammation leading to immunosuppression.