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Predictive value of C-X-C motif chemokine receptor 4-directed molecular imaging in patients with advanced adrenocortical carcinoma

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Title: Predictive value of C-X-C motif chemokine receptor 4-directed molecular imaging in patients with advanced adrenocortical carcinoma
Authors: Wiebke Schloetelburg, Philipp E. Hartrampf, Aleksander Kosmala, Sebastian E. Serfling, Niklas Dreher, Andreas Schirbel, Martin Fassnacht, Andreas K. Buck, Rudolf A. Werner, Stefanie Hahner
Source: Eur J Nucl Med Mol Imaging
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Adult, ddc:610, Receptors, CXCR4, Middle Aged, Adrenal Cortex Neoplasms/pathology [MeSH], Female [MeSH], Aged [MeSH], Adult [MeSH], Humans [MeSH], Adrenocortical Carcinoma/diagnostic imaging [MeSH], Adrenal Cortex Neoplasms/metabolism [MeSH], Positron Emission Tomography Computed Tomography [MeSH], Peptides, Cyclic [MeSH], Predictive Value of Tests [MeSH], Middle Aged [MeSH], Adrenocortical Carcinoma/pathology [MeSH], Original Article, Adrenal Cortex Neoplasms/diagnostic imaging [MeSH], Male [MeSH], Prognosis [MeSH], Adrenocortical Carcinoma/metabolism [MeSH], Receptors, CXCR4/metabolism [MeSH], Coordination Complexes [MeSH], Prognosis, Peptides, Cyclic, Adrenal Cortex Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Coordination Complexes, Predictive Value of Tests, Positron Emission Tomography Computed Tomography, Adrenocortical Carcinoma, Humans, Female, Aged
Description: Background In patients affected with adrenocortical carcinoma (ACC), C-X-C motif chemokine receptor 4 (CXCR4) is highly expressed in sites of disease in an ex-vivo setting. We aimed to determine the predictive value of CXCR4-targeting [68Ga]Ga-PentixaFor PET/CT for outcome when compared to clinical parameters. Methods We identified 41 metastasized ACC patients imaged with [68Ga]Ga-PentixaFor PET/CT. Scans were assessed visually and on a quantitative level by manually segmenting the tumor burden (providing tumor volume [TV], peak/mean/maximum standardized uptake values [SUV] and tumor chemokine receptor binding on the cell surface [TRB], defined as SUVmean multiplied by tumor volume). Clinical parameters included sex, previous therapies, age, Weiss-Score, and Ki67 index. Following imaging, overall survival (OS) was recorded. Results After [68Ga]Ga-PentixaFor PET/CT, median OS was 9 months (range, 1–96 months). On univariable analysis, only higher TRB (per 10 ml, HR 1.004, 95%CI: 1.0001–1.007, P = 0.005) and presence of CXCR4-positive peritoneal metastases (PM) were associated with shorter OS (HR 2.03, 95%CI: 1.03–4.02, P = 0.04). Presence of CXCR4-positive liver metastases (LM) trended towards significance (HR 1.85, 0.9–4.1, P = 0.11), while all other parameters failed to predict survival. On multivariable analysis, only TRB was an independent predictor for OS (HR 1.0, 95%CI: 1.00-1.001, P = 0.02). On Kaplan-Meier analysis, TRB above median (13.3 months vs. below median, 6.4 months) and presence of CXCR4-positive PM (6.4 months, vs. no PM, 11.4 months) were associated with shorter survival (P P = 0.07). Conclusions In advanced ACC, elevated tumor chemokine receptor binding on the tumor cell surface detected through [68Ga]Ga-PentixaFor PET/CT is an independent predictor for OS, while other imaging and clinical parameters failed to provide relevant prognostic information.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1619-7089
1619-7070
DOI: 10.1007/s00259-024-06800-z
Access URL: https://pubmed.ncbi.nlm.nih.gov/38896128
https://repository.publisso.de/resource/frl:6520429
https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/39213
https://doi.org/10.1007/s00259-024-06800-z
https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-392131
https://opus.bibliothek.uni-wuerzburg.de/files/39213/00259_2024_Article_6800.pdf
Rights: CC BY
Accession Number: edsair.doi.dedup.....b6ccab1b0af394c246fe4600bbfada8b
Database: OpenAIRE
Description
Abstract:Background In patients affected with adrenocortical carcinoma (ACC), C-X-C motif chemokine receptor 4 (CXCR4) is highly expressed in sites of disease in an ex-vivo setting. We aimed to determine the predictive value of CXCR4-targeting [68Ga]Ga-PentixaFor PET/CT for outcome when compared to clinical parameters. Methods We identified 41 metastasized ACC patients imaged with [68Ga]Ga-PentixaFor PET/CT. Scans were assessed visually and on a quantitative level by manually segmenting the tumor burden (providing tumor volume [TV], peak/mean/maximum standardized uptake values [SUV] and tumor chemokine receptor binding on the cell surface [TRB], defined as SUVmean multiplied by tumor volume). Clinical parameters included sex, previous therapies, age, Weiss-Score, and Ki67 index. Following imaging, overall survival (OS) was recorded. Results After [68Ga]Ga-PentixaFor PET/CT, median OS was 9 months (range, 1–96 months). On univariable analysis, only higher TRB (per 10 ml, HR 1.004, 95%CI: 1.0001–1.007, P = 0.005) and presence of CXCR4-positive peritoneal metastases (PM) were associated with shorter OS (HR 2.03, 95%CI: 1.03–4.02, P = 0.04). Presence of CXCR4-positive liver metastases (LM) trended towards significance (HR 1.85, 0.9–4.1, P = 0.11), while all other parameters failed to predict survival. On multivariable analysis, only TRB was an independent predictor for OS (HR 1.0, 95%CI: 1.00-1.001, P = 0.02). On Kaplan-Meier analysis, TRB above median (13.3 months vs. below median, 6.4 months) and presence of CXCR4-positive PM (6.4 months, vs. no PM, 11.4 months) were associated with shorter survival (P P = 0.07). Conclusions In advanced ACC, elevated tumor chemokine receptor binding on the tumor cell surface detected through [68Ga]Ga-PentixaFor PET/CT is an independent predictor for OS, while other imaging and clinical parameters failed to provide relevant prognostic information.
ISSN:16197089
16197070
DOI:10.1007/s00259-024-06800-z