1. [18F]FDG Positron Emission Tomography within Two Weeks of Starting Erlotinib Therapy Can Predict Response in Non-Small Cell Lung Cancer Patients
- Author
-
Pacôme Fosse, Mammar Hachemi, Thierry Urban, O. Couturier, Franck Lacœuille, José Hureaux, and L. Vervueren
- Subjects
Male ,Lung Neoplasms ,Time Factors ,Epidemiology ,Cancer Treatment ,PET imaging ,Lung and Intrathoracic Tumors ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Clinical Epidemiology ,Erlotinib Hydrochloride ,Prospective cohort study ,Multidisciplinary ,medicine.diagnostic_test ,Middle Aged ,3. Good health ,Survival Rate ,Oncology ,Positron emission tomography ,030220 oncology & carcinogenesis ,Medicine ,Female ,Erlotinib ,Radiology ,Cancer Epidemiology ,medicine.drug ,Research Article ,Adult ,Drugs and Devices ,Drug Research and Development ,Clinical Research Design ,Disease-Free Survival ,03 medical and health sciences ,Fluorodeoxyglucose F18 ,medicine ,Carcinoma ,Humans ,Lung cancer ,Survival rate ,Biology ,Protein Kinase Inhibitors ,Aged ,Population Biology ,business.industry ,Cancers and Neoplasms ,medicine.disease ,Non-Small Cell Lung Cancer ,Clinical trial ,Radiography ,Positron-Emission Tomography ,Nuclear medicine ,Quinazolines ,Radiopharmaceuticals ,business - Abstract
Purpose The aim of this prospective study was to evaluate whether [18F]FDG-PET/CT, performed within two weeks of starting erlotinib therapy can predict tumor response defined by RECIST 1.1 criteria after 8 weeks of treatment in patients with inoperable (stage IIIA to IV) non-small cell lung cancer patients. Patients and Methods Three [18F]FDG-PET/CT scans were acquired in 12 patients before (5±4 days) and after 9±3 days (early PET) and 60±6 days (late PET) of erlotinib therapy. Conventional evaluation, including at least chest CT (baseline versus after 8 weeks of treatment), was performed according to RECIST 1.1 criteria. Change in [18F]FDG uptake was compared with conventional response, progression-free survival (PFS), and overall survival (OS). Results By using ROC analysis, the Area Under the Curve for prediction of metabolic non-progressive disease (mNP) by early PET was 0.86 (95% CI, 0.62 to 1.1; P = 0.04) at a cut-off of 21.6% reduction in maximum Standardized Uptake Value (SUVmax). This correctly classified 11/12 patients (7 with true progressive disease; 4 with true non-progressive disease; 1 with false progressive disease). Non-progressive disease after 8 weeks of treatment according to RECIST 1.1 criteria was significantly more frequent in patients classified mNP (P = 0.01, Fisher's exact test). mNP patients showed prolonged PFS (HR = 0.27; 95% CI, 0.04 to 0.59; P
- Published
- 2014