[18F]Fluorothymidine Positron Emission Tomography before and 7 Days after Gefitinib Treatment Predicts Response in Patients with Advanced Adenocarcinoma of the Lung

Purpose: To evaluate the usefulness of 3′-deoxy-3′-[ 18 F]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 o...

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Published in:	Clinical cancer research 2008-11, Vol.14 (22), p.7423-7429
Main Authors:	Sohn, Hee-Jung, Yang, You-Jung, Ryu, Jin-Sook, Oh, Seung Jun, Im, Ki Chun, Moon, Dae Hyuk, Lee, Dae Ho, Suh, Cheolwon, Lee, Jung-Shin, Kim, Sang-We
Format:	Article
Language:	eng
Subjects:	adenocarcinoma Adenocarcinoma - diagnostic imaging Adenocarcinoma - drug therapy Adenocarcinoma - pathology Adult Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Female Fluorine Radioisotopes fluorothymidine gefitinib Humans Kaplan-Meier Estimate lung Lung Neoplasms - diagnostic imaging Lung Neoplasms - drug therapy Lung Neoplasms - pathology Male Middle Aged Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - pathology Positron-Emission Tomography Prognosis Quinazolines - therapeutic use Radiopharmaceuticals ROC Curve Thymidine Time Tomography, X-Ray Computed
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Summary:	Purpose: To evaluate the usefulness of 3′-deoxy-3′-[ 18 F]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.
ISSN:	1078-0432 1557-3265