[18F]Fluorothymidine positron emission tomography before and 7 days after gefitinib treatment predicts response in patients with advanced adenocarcinoma of the lung.

Abstract

PURPOSE:

To evaluate the usefulness of 3'-deoxy-3'-[18F]fluorothymidine (FLT)-positron emission tomography (PET) for predicting response and patient outcome of gefitinib therapy in patients with adenocarcinoma of the lung.

EXPERIMENTAL DESIGN:

Nonsmokers with advanced or recurrent adenocarcinoma of the lung were eligible. FLT-PET images of the thorax were obtained before and 7 days after the start of gefitinib (250 mg/d) therapy, the maximum standardized uptake values (SUVmax) of primary tumors were measured, and the percent changes in SUVmax were calculated. After 6 weeks of therapy, the responses were assessed by computed tomography of the chest.

RESULTS:

Among 31 patients who were enrolled, we analyzed 28 patients for whom we had complete data. Chest computed tomography revealed partial response in 14 (50%), stable disease in 4 (14%), and progressive disease in 10 (36%) after 6 weeks of treatment. Pretreatment SUVmax of the tumors did not differ between responders and nonresponders. At 7 days after the initiation of therapy, the percent changes in SUVmax were significantly different (-36.0 +/- 15.4% versus 10.1 +/- 19.5%; P < 0.001). Decrease of > 10.9% in SUVmax was used as the criterion for predicting response. The positive and negative predictive values were both 92.9%. The time to progression was significantly longer in FLT-PET responders than nonresponders (median, 7.9 versus 1.2 months; P = 0.0041).

CONCLUSION:

FLT-PET can predict response to gefitinib 7 days after treatment in nonsmokers with advanced adenocarcinoma of the lung. The change in tumor SUVmax obtained by FLT-PET seems to be a promising predictive variable.

• Authors: Hee-Jung Sohn, You-Jung Yang, Jin-Sook Ryu, Seung Jun Oh, Ki Chun Im, Dae Hyuk Moon, Dae Ho Lee, Cheolwon Suh, Jung-Shin Lee, Sang-We Kim
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 14 Issue 22 Pg. 7423-9 (Nov 15 2008) ISSN: 1078-0432 [Print] United States
• PMID: 19010859 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Fluorine Radioisotopes
• Quinazolines
• Radiopharmaceuticals
• Gefitinib
• Thymidine

Topics

• Adenocarcinoma (diagnostic imaging, drug therapy, pathology)
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Female
• Fluorine Radioisotopes
• Gefitinib
• Humans
• Kaplan-Meier Estimate
• Lung Neoplasms (diagnostic imaging, drug therapy, pathology)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, pathology)
• Positron-Emission Tomography
• Prognosis
• Quinazolines (therapeutic use)
• ROC Curve
• Radiopharmaceuticals
• Thymidine
• Time
• Tomography, X-Ray Computed