Online citations, reference lists, and bibliographies.
Please confirm you are human
(Sign Up for free to never see this)
← Back to Search

Can 3'-deoxy-3'-(18)F-fluorothymidine Or 2'-deoxy-2'-(18)F-fluoro-d-glucose PET/CT Better Assess Response After 3-weeks Treatment By Epidermal Growth Factor Receptor Kinase Inhibitor, In Non-small Lung Cancer Patients? Preliminary Results.

Amit Bhoil, B. Singh, Navneet Singh, R. Kashyap, A. Watts, S. Sarika, B. Mittal
Published 2014 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
The objectives of this study was to study the diagnostic efficacy of 3'-deoxy-3'-fluorine-18-fluorothymidine ((18)F-FLT) and of 2'-deoxy-2'-(18)F-fluoro-d-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) for response evaluation following three weeks treatment by epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in non small cell lung cancer (NSCLC) patients. Fifteen patients of advanced stage (IIIB-IV) NSCLC planned for oral 1st or 2nd/3rd line EGFR-TKI treatment were enrolled in the study. Baseline, prior to treatment, and follow-up after three weeks, (18)F-FLT and (18)F-FDG PET/CT imaging was performed in all patients. The standard uptake lean body mass (SULpeak) and total lesion glycolysis (TLG) values of the hottest lesions were calculated in all patients using semi-quantitative analysis. Statistical analysis on PET semi-quantitative data was used to evaluate the overall survival (OS) and progression free survival (PFS). The patients were either classified as responders or non-responders or at a steady state according to the PET response criteria in solid tumors (PERCIST). The receiver operating characteristic curve (ROC) analysis was done on the (18)F-FDG PET/CT clinical responders, to derive the cut-off values on the corresponding data sets between responders and non responders. Results showed that in responders (18)F-FDG SULpeak values better predicted OS and PFS values when compared to (18)F-FLT SULpeak values and also were a better predictor of OS as compared to the TLG values. In responders, the ROC analysis carried out on (18)F-FLT PET/CT imaging data in responders indicated a decrease of ≥22% in SULpeak and a decrease of ≥0.7 in absolute values. Three (3/15) patients developed resistance to EGFR-TKI treatment at 3 months of follow-up. In conclusion, in both responders and in non responders, patients with NSCLC treated for 3 weeks by EGFR-TKI, both OS and PFS were better predicted by (18)F -FDG SULpeak than by (18)F -FLT SULpeak. Although, the difference was only borderline, yet, (18)F -FDG SULpeak was a better predictor of OS compared to TLG values. However, to validate these findings, studies need to be carried in a larger number of patients.
This paper references
10.1038/nrc2088
Epidermal growth factor receptor mutations in lung cancer
S. Sharma (2007)
10.2217/fon.10.30
Clinical outcomes in non-small-cell lung cancer in relation to expression of predictive and prognostic biomarkers.
Navneet Singh (2010)
10.1128/AAC.36.4.808
Comparisons of anti-human immunodeficiency virus activities, cellular transport, and plasma and intracellular pharmacokinetics of 3'-fluoro-3'-deoxythymidine and 3'-azido-3'-deoxythymidine.
X. Kong (1992)
10.1007/s00259-004-1687-6
[18F]FLT-PET in oncology: current status and opportunities
L. B. Been (2004)
10.1007/s11523-010-0163-4
Activity and safety of erlotinib as second- and third-line treatment in elderly patients with advanced non-small cell lung cancer: a phase II trial
D. Rossi (2010)
10.1093/jnci/92.3.205
New Guidelines to Evaluate the Response to Treatment in Solid Tumors.
P. Therasse (2000)
10.4103/0972-3919.130274
FLT PET-CT in evaluation of treatment response
B. Sanghera (2014)
10.1158/1078-0432.CCR-0884-02
MIB-1 (KI-67) Proliferation Index and Cyclin-Dependent Kinase Inhibitor p27Kip1 Protein Expression in Nephroblastoma
M. Ghanem (2004)
10.2967/jnumed.108.057307
From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors
R. Wahl (2009)
10.1158/1078-0432.CCR-08-0312
[18F]Fluorothymidine Positron Emission Tomography before and 7 Days after Gefitinib Treatment Predicts Response in Patients with Advanced Adenocarcinoma of the Lung
Hee-Jung Sohn (2008)
10.1007/s00259-007-0379-4
Imaging early changes in proliferation at 1 week post chemotherapy: a pilot study in breast cancer patients with 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography
L. Kenny (2007)
10.1016/J.JAMCOLLSURG.2004.02.024
Sequential preoperative fluorodeoxyglucose-positron emission tomography assessment of response to preoperative chemoradiation: a means for determining longterm outcomes of rectal cancer.
J. Guillem (2004)
10.1016/S0969-8051(01)00289-X
A new precursor for the radiosynthesis of [18F]FLT.
S. J. Martin (2002)
Monitoring of therapy in androgen-dependent prostate tumor model by measuring tumor proliferation.
N. Oyama (2004)
10.3892/MCO.2013.100
Target therapy in NSCLC patients: Relevant clinical agents and tumour molecular characterisation.
P. Ulivi (2013)
10.1097/RLU.0b013e3182639747
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
Deniz Kahraman (2012)
10.1016/S1470-2045(10)70112-1
Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled phase 3 study.
F. Cappuzzo (2010)
10.1016/j.ijrobp.2008.12.039
Imaging cellular proliferation during chemo-radiotherapy: a pilot study of serial 18F-FLT positron emission tomography/computed tomography imaging for non-small-cell lung cancer.
S. Everitt (2009)
10.1007/s00259-003-1257-3
[18F]FLT PET for diagnosis and staging of thoracic tumours
H. Dittmann (2003)
10.1056/NEJMct0807960
Treatment of non-small-cell lung cancer with erlotinib or gefitinib.
V. Cataldo (2011)
10.1007/s00259-007-0679-8
The role of 18F-FLT in cancer imaging: does it really reflect proliferation?
A. Dimitrakopoulou-Strauss (2007)
10.1200/JCO.2010.32.4939
Early prediction of nonprogression in advanced non-small-cell lung cancer treated with erlotinib by using [(18)F]fluorodeoxyglucose and [(18)F]fluorothymidine positron emission tomography.
T. Zander (2011)
10.1158/1078-0432.CCR-06-0368
Monitoring Tumor Glucose Utilization by Positron Emission Tomography for the Prediction of Treatment Response to Epidermal Growth Factor Receptor Kinase Inhibitors
H. Su (2006)
10.1097/JTO.0b013e3181c3f5f7
Intercycle Delays during Chemotherapy of Non-small Cell Lung Cancer in a Health Care Resource-Constrained Setting and Their Effect on Overall Survival
Navneet Singh (2010)
10.2967/jnumed.111.095257
18F-FDG PET/CT for Monitoring Treatment Responses to the Epidermal Growth Factor Receptor Inhibitor Erlotinib
M. Benz (2011)
10.2967/jnumed.111.101402
18F-FDG PET/CT Metabolic Tumor Volume and Total Lesion Glycolysis Predict Outcome in Oropharyngeal Squamous Cell Carcinoma
Remy Lim (2012)
Imaging proliferation in lung tumors with PET: 18F-FLT versus 18F-FDG.
A. Buck (2003)
New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.
P. Therasse (2000)
10.1016/0360-3016(94)90019-1
Enhanced expression of thymidine kinase in human cells following ionizing radiation.
D. Boothman (1994)
10.1158/1078-0432.CCR-10-2763
Changes in 18F-Fluorodeoxyglucose and 18F-Fluorodeoxythymidine Positron Emission Tomography Imaging in Patients with Non–Small Cell Lung Cancer Treated with Erlotinib
L. Mileshkin (2011)
10.1016/S1470-2045(11)70393-X
Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial.
R. Rosell (2012)
Automated FLT synthesis using 3-N-Boc-1-(5-O4,4’-dimethoxytrityl)-3-O-nosyl-2-deoxy-β-lyxofuranosyl) thymine as precursor
C. Mosdzianowski (2001)
10.1007/s00259-011-1834-9
Baseline 18F-FDG PET image-derived parameters for therapy response prediction in oesophageal cancer
M. Hatt (2011)
10.1007/s00259-011-1758-4
The prognostic value of functional tumor volume and total lesion glycolysis in patients with colorectal cancer liver metastases undergoing 90Y selective internal radiation therapy plus chemotherapy
S. Gulec (2011)
10.1016/S8756-3452(08)70369-4
Erlotinib in Previously Treated Non-Small-Cell Lung Cancer
L. Tanoue (2007)



This paper is referenced by
10.1967/s002449910904
18F-FDG PET/CT in therapy response and in predicting responders or non-responders in malignant pleural mesothelioma patients, by using semi-quantitative mRECIST and EORTC criteria.
A. Niccoli Asabella (2018)
10.1007/978-3-319-26236-9_87
Novel Positron-Emitting Radiopharmaceuticals
Mirkka Sarparanta (2017)
10.1097/RLU.0000000000000881
99mTc-MDM Brain SPECT for the Detection of Recurrent/Remnant Glioma—Comparison With ceMRI and 18F-FLT PET Imaging: Initial Results
B. Singh (2015)
10.1186/s13550-017-0258-3
A comparison of FLT to FDG PET/CT in the early assessment of chemotherapy response in stages IB–IIIA resectable NSCLC
John P. Crandall (2017)
Summarizing discussion and future perspectives
(2019)
10.1007/978-1-4939-2047-1_4
Biomarkers as Prognostic, Predictive, and Surrogate Endpoints
F. Passiglia (2015)
10.1186/s13550-019-0472-2
18F-FDG and 11C-4DST PET/CT for evaluating response to platinum-based doublet chemotherapy in advanced non-small cell lung cancer: a prospective study
R. Minamimoto (2019)
10.1007/978-3-319-26067-9_87-1
Emerging Radiopharmaceuticals in Clinical Oncology
Mirkka Sarparanta (2016)
10.1007/s13139-016-0453-6
PET Imaging-Based Phenotyping as a Predictive Biomarker of Response to Tyrosine Kinase Inhibitor Therapy in Non-small Cell Lung Cancer: Are We There Yet?
V. Gerbaudo (2016)
10.1016/j.ejca.2015.11.018
A systematic review on [(18)F]FLT-PET uptake as a measure of treatment response in cancer patients.
V. Bollineni (2016)
10.1016/j.cpet.2016.08.008
Molecular Imaging and Precision Medicine in Lung Cancer.
K. Zukotynski (2017)
Semantic Scholar Logo Some data provided by SemanticScholar