PD-L1-targeted PET imaging for non-invasive assessment of immunotherapy response in lung cancer

BACKGROUND: Immune checkpoint inhibitors have improved outcomes for several malignancies; however, there remains a lack of accurate, non-invasive methods to assess tumor PD-L1 expression levels and guide immunotherapy. This study aimed to evaluate the role of PD-L1-targeted positron emission tomography (PET) imaging in predicting immunotherapy response and prognosis in lung cancer. METHODS: F]FDG uptake, and PD-L1 expression with immunotherapy response were analyzed, along with their predictive values for immunotherapy efficacy and outcomes. RESULTS: F]FDG uptake demonstrated significantly longer progression-free survival (PFS) than those with lower uptake (p=0.033 and p<0.001, respectively). However, no significant difference in PFS was observed between patients with high and low PD-L1 expression, using either a 50% (p=0.487) or 1% (p=0.100) cut-off. CONCLUSIONS: F]FDG PET and immunohistochemistry-based PD-L1 assessment in predicting immunotherapy response and prognosis. These findings offer new insights for evaluating immunotherapy efficacy and guiding individualized tumor treatment.