Usefulness of FDG-PET for early prediction of the response to gefitinib in non-small cell lung cancer
Usefulness of FDG-PET for early prediction of the response to gefitinib in non-small cell lung cancer
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DOI：
10.1016/j.lungcan.2007.08.012
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发表时间：
2008-02-01
期刊：
影响因子：
5.3
通讯作者：
Mori, Masatomo
中科院分区：
文献类型：
--
作者：
Sunaga, Noriaki;Oriuchi, Noboru;Mori, Masatomo
正电子发射断层扫描(PET)测量肿瘤摄取F-18-氟代脱氧葡萄糖(FDG)的增加反映了肿瘤细胞的葡萄糖代谢和增殖活性。我们进行了一项研究，以评估FDG-PET在早期预测晚期非小细胞肺癌(NSCLC)对吉非替尼(一种表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)的反应)的有效性。5例非小细胞肺癌患者在吉非替尼治疗后第2天和第4周接受FDG-PET检查，与治疗前的FDG-PET比较，评估FDG摄取的变化。FDG摄取被评估为靶区的最大标准摄取值(SUVmax)，这是常规CT可评估的。根据CT评估，2例患者表现为部分缓解(PR)，2例为病情稳定(SD)且反应轻微，1例为进展性疾病(PD)。PR和SD患者服药后第2天SUVmax分别下降61+/-18%(标准差)和59+/-12%，服药4周后分别下降26+/-6%和43+/-10%。两名SD患者在开始治疗的2天内FDG摄取减少，并获得了超过12个月的无进展生存(PFS)。相比之下，PD患者的SUVmax在第2天增加到153+/-21%，在第4周增加232+/-73%。目前的初步研究表明，FDG-PET可能能够预测晚期非小细胞肺癌患者在治疗早期对吉非替尼的反应，并可能具有潜在的预后机制。(C)2007爱思唯尔爱尔兰有限公司。保留所有权利。
Increased tumor uptake of F-18-fluorodeoxyglucose (FDG) measured by positron emission tomography (PET) reflects glucose metabolism and proliferative activity of tumor cells. We conducted a study to assess the usefulness of FDG-PET for early prediction of the response to gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), in advanced non-small cell lung cancer (NSCLC). Five NSCLC patients underwent FDG-PET to evaluate changes in FDG uptake at day 2 and 4 weeks after the initiation of gefitinib therapy compared with FDG-PET prior to therapy. FDG uptake was evaluated as the maximum standardized uptake value (SUVmax) of the target lesions, which were assessable by conventional CT. Based on the CT evaluation, two patients exhibited a partial response (PR), two patients had stable disease (SD) with a minor response, and one patient had progressive disease (PD). In patients with PR and SD, SUVmax decreased by 61 +/- 18% (standard deviation) and 59 +/- 12%, respectively, on day 2, and by 26 +/- 6 and 43 +/- 10%, respectively, at 4 weeks after the initiation of gefitinib. Two patients with SD had decreased FDG uptake within 2 days of initiation of therapy, and achieved progression-free survival (PFS) of more than 12 months. In contrast, SUVmax increased up to 153 +/- 21% at 2 days and 232 +/- 73% at 4 weeks in a patient with PD. The present preliminary study suggests that FDG-PET may be able to predict response to gefitinib in the early stage of therapy in patients with advanced NSCLC and may have a potential prognostic rote. (C) 2007 Elsevier Ireland Ltd. All rights reserved.