Prognostic Value of PET-Based Metabolic Markers in Nivolumab-Treated NSCLC

Objective: This study aimed to assess the prognostic significance of 18F-FDG PET/CT metabolic parameters in patients with non-small cell lung cancer (NSCLC) receiving nivolumab as second-line therapy. The study also explored associations between these parameters, treatment response, and survival outcomes. Methods: A retrospective analysis was performed on 32 stage IV NSCLC patients who received at least four doses of nivolumab and underwent both baseline and follow-up PET/CT scans. Metabolic parameters, including SUVmax, SUVmean, total metabolic tumor volume (tMTV), and total lesion glycolysis (tTLG), were measured. Treatment response was classified according to EORTC criteria. Kaplan–Meier analysis and log-rank tests were applied for survival comparisons, and non-parametric methods evaluate associations. Results: Patients with partial metabolic response demonstrated significantly longer post-nivolumab survival. Post-treatment SUVmax, SUVmean, and tTLG differed significantly among response categories. Pretreatment tMTV and tTLG, and post-treatment SUVmax, SUVmean, and tTLG, were significantly associated with mortality (p