The predictive value of 18F-FDG-PET early evaluation in patients with metastatic gastric adenocarcinoma treated with chemotherapy plus cetuximab.

Abstract

BACKGROUND:

The aim of the study was to evaluate whether the therapy-induced reduction of the (18)F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) maximum standardized uptake value in patients with advanced gastric adenocarcinoma treated with chemotherapy plus cetuximab could predict the objective response and outcome early during the treatment.

METHODS:

The study was performed as a part of a phase II trial evaluating cetuximab plus the leucovorin/5-fluorouracil/irinotecan (FOLFIRI) regimen. The objective response was evaluated according to the response evaluation criteria in solid tumors (RECIST) every 6 weeks. The early metabolic response evaluated by 18F-FDG-PET was assessed according to our own evaluated cutoff value (<35%) after receiver operating characteristic (ROC) analysis.

RESULTS:

Twenty of 22 patients had positive baseline 18F-FDG-PET. The best RECIST response was: complete response (CR), 3; partial response (PR), 9; stable disease (SD), 8. Twelve patients (60%) were classified as metabolic responders and 8 (40%) as nonresponders. At the median follow-up time of 11 months, median time to disease progression (TTP) and overall survival (OS) for early metabolic responders versus nonresponders were 11 versus 5 months (P = 0.0016) and 16 versus 6 months (P = 0.1493), respectively.

CONCLUSION:

The early metabolic response evaluated by 18F-FDG-PET predicted the clinical outcome in this series of patients with advanced gastric cancer treated with chemotherapy plus cetuximab.

• Authors: Francesca Di Fabio, Carmine Pinto, Fabiola L Rojas Llimpe, Stefano Fanti, Paolo Castellucci, Ciro Longobardi, Vita Mutri, Chiara Funaioli, Francesca Sperandi, Stefania Giaquinta, Andrea A Martoni
• Journal: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association (Gastric Cancer) Vol. 10 Issue 4 Pg. 221-7 ( 2007) ISSN: 1436-3291 [Print] Japan
• PMID: 18095077 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• ErbB Receptors
• Cetuximab
• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Adenocarcinoma (diagnostic imaging, drug therapy)
• Adult
• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Camptothecin (analogs & derivatives, therapeutic use)
• Cetuximab
• Clinical Trials, Phase II as Topic
• ErbB Receptors
• Female
• Fluorodeoxyglucose F18
• Fluorouracil (therapeutic use)
• Humans
• Leucovorin (therapeutic use)
• Male
• Middle Aged
• Positron-Emission Tomography
• Predictive Value of Tests
• Prospective Studies
• Radiopharmaceuticals
• Remission Induction
• Stomach Neoplasms (diagnostic imaging, drug therapy)
• Treatment Outcome