Document Detail


Tumor lesion glycolysis and tumor lesion proliferation for response prediction and prognostic differentiation in patients with advanced non-small cell lung cancer treated with erlotinib.
MedLine Citation:
PMID:  23027207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim was to assess the value of tumor lesion glycolysis (TLG) and tumor lesion proliferation (TLP) determined by FDG and 3'-deoxy-3'-F-fluorothymidine (FLT) PET for response prediction and prognostic differentiation in patients with advanced non-small cell lung cancer (NSCLC) treated with erlotinib.
PATIENTS AND METHODS: FDG-PET and FLT-PET were performed in 30 patients with untreated Stage IV NSCLC before start of therapy, 1 (early) and 6 (late) weeks after erlotinib treatment. Functional tumor volume parameters including TLG in FDG-PET and TLP in FLT-PET were measured in the sum of up to 5 lesions per scan. Metabolic response was assessed using different cutoff values for percentage changes of TLG and TLP. Absolute baseline and residual levels of TLG and TLP were used for dichotomizing the patients into 2 groups. Kaplan-Meier analysis and the log-rank test were performed to analyze the association with progression-free survival (PFS).
RESULTS: Patients with a metabolic response measured by early changes of TLP and late changes of TLG and TLP showed a significantly better PFS than metabolically nonresponding patients. A lower cutoff value of 20% or 30% for definition of metabolic response showed better differentiation between metabolically responding and nonresponding patients in cases where the 45% cutoff value revealed no significant results. Furthermore, patients with lower absolute early and late residual TLG and TLP levels had a significantly prolonged PFS. In contrast, absolute baseline TLG and TLP levels showed no significant association with PFS.
CONCLUSIONS: In patients with advanced NSCLC, percentage changes of TLG and TLP and absolute residual TLG and TLP levels under erlotinib treatment emerged as strong predictive factors for PFS. Our findings indicate that a cutoff value of 20% or 30% for definition of metabolic response measured by percentage changes of TLG and TLP provides suitable results for response prediction, which should be further validated.
Authors:
Deniz Kahraman; Arne Holstein; Matthias Scheffler; Thomas Zander; Lucia Nogova; Adriaan A Lammertsma; Ronald Boellaard; Bernd Neumaier; Markus Dietlein; Jürgen Wolf; Carsten Kobe
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  37     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-10     Completed Date:  2013-02-26     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1058-64     Citation Subset:  IM    
Affiliation:
Department for Nuclear Medicine, University Hospital of Cologne, Germany. deniz.kahraman@uk-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Carcinoma, Non-Small-Cell Lung / drug therapy*,  metabolism*,  pathology,  radionuclide imaging
Cell Proliferation / drug effects
Dideoxynucleosides / diagnostic use
Disease-Free Survival
Female
Fluorodeoxyglucose F18 / diagnostic use
Glycolysis* / drug effects
Humans
Kaplan-Meier Estimate
Lung Neoplasms / drug therapy*,  metabolism*,  pathology,  radionuclide imaging
Male
Middle Aged
Neoplasm Staging
Positron-Emission Tomography
Prognosis
Quinazolines / pharmacology,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Dideoxynucleosides; 0/Quinazolines; 63503-12-8/Fluorodeoxyglucose F18; J4T82NDH7E/erlotinib; PG53R0DWDQ/alovudine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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