Association of biomarkers of insulin resistance and inflammation with PET CT SUV values in stage IV non-small cell lung cancer (NSCLC).

e20589 Background: PET CT is the imaging technique of choice for staging nodal and metastatic disease in NSCLC. Standardized Uptake Value (SUV) on PET CT is a quantification of FDG uptake and a surrogate of glycolysis. The aim of this project was to correlate pretreatment levels of circulating biomarkers of insulin resistance and inflammation with SUV on FDG PETs performed as part of routine care in stage IV NSCLC patients receiving platinum doublet chemotherapy. Methods: Pretreatment serum from 137 patients with frontline stage IV NSCLC were evaluated with the Bio-Plex Pro Human Diabetes Assay Panel and the Milliplex Human High Sensitivity T Cell Panel. All patients were treated with standard platinum doublet based chemotherapy. 80 patients had PET CT scans available to record maximal SUV (SUVmax). Associations of biomarkers with SUVmax were assessed using a Spearman’s Rank Correlation Coefficient. Results: SUVmax levels ranged from 2.2 to 41.9, mean 10.2, median 9.1. High levels of endocrine markers glucagon, visfatin, glucagon like peptide-1, ghrelin, resistin, C-peptide, and adipsin, and high levels of inflammatory markers ITAC, MIP-3α, IL-12, and IL-13 were associated with shortened overall survival (OS). Low levels of adiponectin (low values associated with obesity) were associated with shortened OS. High levels of some of these markers including MIP-1α, C-peptide, resistin, IL-8, and glucagon were significantly associated with high SUVmax, and low levels of adiponectin were significantly associated with high SUVmax (see table). Conclusions: High values of several biomarkers of insulin resistance and inflammation were associated with shortened survival in frontline NSCLC patients receiving platinum double therapy. Despite the lower number of patients with PETs, we found several biomarkers associated with high SUVmax. This study suggests that patients with high FDG uptake on PET may benefit from agents which modulate insulin resistance and/or inflammation. Biomarkers SUVmax (n = 80) Spearman Correlation p-value Adiponectin -0.258 0.021 MIP-1α 0.239 0.033 C-Peptide 0.242 0.030 Resistin 0.250 0.025 IL-8 0.263 0.018 Glucagon 0.268 0.016