This retrospective study evaluated whether pre-treatment apparent diffusion coefficient (ADC) values from diffusion-weighted imaging could predict clinical outcomes in patients with advanced or locally advanced cervical cancer undergoing PD-1 inhibitor therapy. Conducted at Wuhan Union Hospital, the study included 167 patients treated between May 1, 2020, and December 31, 2023. Researchers measured whole tumor ADC (wADC) and substantial tumor ADC (sADC), which excludes necrotic, cystic, and vascular regions, on the largest tumor slice. Optimal cut-off values for ADC and inflammatory markers were determined using X-tile software based on overall survival (OS). The analysis revealed that a lower sADC was significantly associated with worse progression-free survival (PFS) and overall survival (OS), with hazard ratios of 1.81 (95% CI: 1.18-2.80, P=0.005) and 2.40 (95% CI: 1.36-4.21, P=0.002), respectively. In contrast, wADC did not show a significant prognostic correlation with PFS (HR=0.64, 95% CI: 0.39-1.06, P=0.123) or OS (HR=0.62, 95% CI: 0.32-1.19, P=0.209). Multivariate Cox regression confirmed low-sADC as an independent risk factor for both OS (HR=2.15, 95% CI: 1.14-4.03, P=0.017) and PFS (HR=1.70, 95% CI: 1.08-2.67, P=0.021). These findings suggest that sADC could serve as a prognostic biomarker in this patient population.
If you or someone you know is facing advanced cervical cancer, understanding how treatment might work is crucial. A recent study looked at how certain imaging results could predict outcomes for patients receiving PD-1 inhibitors, a type of immunotherapy. The findings showed that lower values of substantial tumor ADC, which measures how water moves in tumor tissue, were linked to significantly worse progression-free survival and overall survival. In simpler terms, if the ADC values are low, patients might not respond as well to the treatment. This information could help doctors make better decisions about treatment plans, potentially steering patients toward options that could work better for them. Knowing this could empower patients and their families to have informed discussions with their healthcare teams about the best path forward.
What this means for you: Lower tumor ADC values may indicate poorer treatment outcomes for cervical cancer patients on PD-1 inhibitors.
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BackgroundTo investigate whether pre-treatment apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI) predict clinical outcomes in patients with advanced or locally advanced cervical cancer undergoing Programmed Death-1 (PD-1) inhibitor therapy. Despite the growing use of immunotherapy, reliable and non-invasive imaging biomarkers to predict treatment response in cervical cancer are lacking.MethodsThis retrospective study analyzed 167 cervical cancer patients treated with PD-1 inhibitors at Wuhan Union Hospital between 01/05/2020 and 31/12/2023. The whole tumor ADC (wADC) and substantial tumor ADC (sADC; excluding necrotic, cystic, and vascular regions) were measured on the largest tumor slice. Optimal cut-off values for ADC and inflammatory markers were determined using X-tile software based on overall survival (OS). Progression-free survival (PFS) and OS were analyzed using Kaplan-Meier curves and Cox regression models.ResultsLower sADC was associated with significantly worse PFS (hazard ratio [HR] = 1.81; 95% confidence interval [CI]: 1.18-2.80; P = 0.005) and OS (HR = 2.40; 95% CI: 1.36-4.21; P = 0.002), whereas wADC showed no significant prognostic correlation with PFS (HR = 0.64; 95% CI: 0.39-1.06; P = 0.123) and OS (HR = 0.62; 95% CI: 0.32-1.19; P = 0.209). Multivariate Cox regression revealed low-sADC as an independent risk factor for OS (HR = 2.15, 95% CI: 1.14-4.03, P = 0.017) and PFS (HR = 1.70, 95% CI: 1.08-2.67, P = 0.021).ConclusionThe substantial tumor ADC (excluding necrotic, cystic, and vascular regions) was associated with prognosis in cervical cancer patients receiving PD-1 inhibitor therapy.