Clinical Report: Enhanced Prognostic Value of Volumetric PET Metrics in NSCLC

Overview

This systematic review and meta-analysis evaluates the prognostic value of baseline metabolic measurements from [18F] FDG PET/CT in patients with advanced non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitor therapy.

Background

Lung cancer, particularly non-small cell lung cancer (NSCLC), represents a significant global health challenge, with high incidence and mortality rates. Immune checkpoint inhibitors (ICIs) have become a standard treatment for advanced NSCLC.

Data Highlights

Key Findings

• Higher MTV is associated with worse PFS and OS in NSCLC patients receiving ICIs.
• TLG also correlates with worse PFS but not OS after multivariable adjustment.
• MTV cut-off values between 50-100 cm³ provide optimal predictive performance.
• MTV remains an independent predictor of both PFS and OS in multivariable analyses.
• Subgroup analyses indicate greater prognostic efficacy of MTV and TLG in Stage IV disease and first-line treatment settings.

Clinical Implications

The findings indicate the potential for incorporating MTV measurements from [18F] FDG PET/CT into prognostic assessments for NSCLC patients undergoing ICI therapy.

Conclusion

Baseline MTV is a prognostic marker for PFS and OS in advanced NSCLC patients treated with ICIs.

Related Resources & Content

1. ASCO Publications, ASCO, 2026 -- Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline
2. European Radiology, 2025 -- [18F]FDG PET/CT: EANM procedure guidelines for tumour imaging: version 3.0
3. the asco post — Metabolic Tumor Volume Predicts CAR T-Cell Therapy Response in LBCL
4. Blood Cancer Journal — Metabolic PET/CT Evaluation of Aggressive Non-Hodgkin Lymphoma Before Axicabtagene Ciloleucel CAR-T Therapy: Indicators of Disease Progression, Survival Outcomes, and Adverse Effects
5. European Radiology — Development and external validation of FDG PET-CT-based models for predicting outcomes in anal squamous cell carcinoma prior to treatment
6. European Radiology — Evaluating the Prognostic Significance of [18F]Fluorodeoxyglucose PET/CT in the Updated Staging Framework for Non-Small Cell Lung Cancer
7. Metabolic Tumor Volume Predicts CAR T-Cell Therapy Response in LBCL
8. Metabolic PET/CT Evaluation of Aggressive Non-Hodgkin Lymphoma Before Axicabtagene Ciloleucel CAR-T Therapy
9. Development and external validation of FDG PET-CT-based models for predicting outcomes in anal squamous cell carcinoma prior to treatment
10. Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline | ASCO Publications
11. [18F]FDG PET/CT: EANM procedure guidelines for tumour imaging: version 3.0 - ScienceDirect