Studies on optimal evaluation of the effect and recurrence of molecular-targeting therapy using positron emission tomography

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Molecular-targeted therapy is advantageous as compared with cytotoxic chemotherapy because it is specific to the target cells. Therapeutic effect is thought to reduce glucose metabolism of malignant cells and makes the uptake of [^<18>F] fluorodeoxyglucose (^<18>F-FDG) lower.Malignant potential of gastrointestinal stromal tumor (GIST) is not easily evaluable prior to the surgical procedure. Pathological analysis demonstrated that the uptake of ^<18>F-FDG by the tumor is related to the cellular proliferative fraction of the resected tumors. These results indicated that ^<18>F-FDG PET has a role to evaluate malignancy of GIST. Comparison of the reduction in the ^<18>F-FDG uptake with the effect of imatinib mesylate is under the investigation.Anti-CD20 monoclonal antibody is effective to malignant lymphoma. ^<18>F-FDG PET is useful for the staging and also the evaluation of antitumor efficacy and the prognosis of malignant lymphoma. In patients with effective therapy, the uptake of ^<18>F-FDG PET decreased even when CT showed residual tumor. These results indicate that ^<18>F-FDG PET has alternative role for the accurate evaluation of the therapeutic effect as compared with the standard method using CT.Bronchial adenocarcinoma with the mutation of epidermal growth factor receptor (EGFR) is highly predictive of the response to gefitinib therapy. Clinical trial of the utility of ^<18>F-FDG PET in the evaluation of the response to gefitinib in patients with lung cancer with EGFR mutation is underway.