FDG-PET based chemotherapy selection for metastatic non-small cell lung cancer

基于FDG-PET的转移性非小细胞肺癌化疗选择

• 批准号: 7498952
• 负责人: Keith D Eaton
• 金额: $ 23.94万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-21 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7498952
• 关键词: Adjuvant; Anatomy; Cancer Etiology; Cancer Patient; Carboplatin; Carboplatin/Paclitaxel; Cessation of life; Chemotherapy-Oncologic Procedure; Cisplatin; Clinical Trials; Data; Diagnosis; Docetaxel/Gemcitabine; Evaluation; Event; Fluorine; Grant; Image; Individual; Malignant neoplasm of lung; Measures; Metabolic; Methods; Monitor; Non-Small-Cell Lung Carcinoma; Outcome; Paclitaxel; Patients; Persons; Platinum; Population; Positron-Emission Tomography; Primary Neoplasm; Prognostic Marker; Rate; Solid Neoplasm; Staging; Standards of Weights and Measures; Techniques; Testing; Toxic effect; Translating; Treatment Protocols; United States; Work; X-Ray Computed Tomography; base; chemotherapy; day; fluorodeoxyglucose; fluorodeoxyglucose positron emission tomography; image guided intervention; improved; mortality; novel; response; size; tool; tumor; uptake

DESCRIPTION (provided by applicant): We propose to test a novel PET (Positron Emission Tomography) imaging-based method to select and optimize the delivery of systemic chemotherapy to patients suffering from metastatic non-small cell lung cancer, the leading cause of cancer death in the United States. We will build on the work of Weber and colleagues, which demonstrated that the change in the primary tumor FDG uptake by PET after a single cycle of platinum-based chemotherapy revealed which metastatic NSCLC (Non-Small Cell Lung Cancer) patients had longer progression-free and overall survival after administration of the entire multi-cycle chemotherapy regimen. We are proposing a clinical trial to test the hypothesis that, for a given patient, outcome from chemotherapy can be improved by determining early tumor response with FDG PET and changing chemotherapy agents in the event of poor response by PET. We will assess response rates in initially non- responding patients who would be expected to have an extremely low response rate if the initial chemotherapy were continued. The ability of FDG-PET to predict response to therapy as measured by CT will also be assessed. Finally, we will evaluate the early and late changes in tumor FDG uptake (Delta SUV) (Standardized Uptake Value) in all subjects and correlate it to their overall survival. This proposal serves to rapidly translate observational data on the predictive power of FDG-PET into an image guided intervention for chemotherapy selection. The data collected will help establish FDG-PET as a valuable tool for monitoring treatment response and for rapidly tailoring chemotherapy. FDG-PET based chemotherapy selection has the potential to improve outcomes for patients with metastatic NSCLC by optimizing the benefit of chemotherapy with tailored therapy. With over 70,000 patients diagnosed with metastatic non-small cell lung cancer each year in the US and a 2% 5-yr survival, even small gains in our ability to optimize therapy would translate into thousands of person-years saved. If validated, this technique could be extended to the neo-adjuvant setting, where improved therapy will result in higher cure rates for patients with operable lung cancer. FDG-PET based chemotherapy selection has the potential to improve outcomes for patients with metastatic NSCLC by optimizing the benefit of chemotherapy with tailored therapy. With over 70,000 patients diagnosed with metastatic non-small cell lung cancer each year in the US and a 2% 5-yr survival, even small gains in our ability to optimize therapy would translate into thousands of person-years saved. If validated, this technique could be extended to the neo-adjuvant setting, where improved therapy will result in higher cure rates for patients with operable lung cancer

描述（由申请人提供）：我们建议测试一种基于PET（正电子发射断层扫描）成像的新方法，以选择和优化转移性非小细胞肺癌患者的全身化疗，转移性非小细胞肺癌是美国癌症死亡的主要原因。我们将建立在Weber及其同事的工作基础上，该工作表明，在单周期铂类化疗后PET对原发性肿瘤FDG摄取的变化揭示了哪些转移性NSCLC（非小细胞肺癌）患者在整个多周期化疗方案给药后具有更长的无进展生存期和总生存期。我们提出了一项临床试验，以测试的假设，即对于一个给定的病人，化疗的结果可以通过确定早期肿瘤反应与FDG PET和改变化疗药物的PET反应差的情况下，改善。我们将评估最初无应答患者的应答率，如果继续初始化疗，这些患者的应答率预计将极低。还将评估FDG-PET预测CT测量的治疗反应的能力。最后，我们将评估所有受试者的肿瘤FDG摄取（Delta SUV）（标准化摄取值）的早期和晚期变化，并将其与总生存期相关联。这一建议有助于快速将FDG-PET预测能力的观察数据转化为化疗选择的图像引导干预。收集的数据将有助于建立FDG-PET作为监测治疗反应和快速定制化疗的有价值的工具。 基于FDG-PET的化疗选择有可能通过优化定制治疗的化疗获益来改善转移性NSCLC患者的结局。在美国，每年有超过70，000名患者被诊断患有转移性非小细胞肺癌，5年生存率为2%，即使我们优化治疗的能力略有提高，也可以节省数千人年。如果得到验证，这项技术可以扩展到新辅助治疗，改善治疗将提高可手术肺癌患者的治愈率。基于FDG-PET的化疗选择有可能通过优化定制治疗的化疗获益来改善转移性NSCLC患者的结局。在美国，每年有超过70，000名患者被诊断患有转移性非小细胞肺癌，5年生存率为2%，即使我们优化治疗的能力略有提高，也可以节省数千人年。如果得到证实，这项技术可以扩展到新辅助治疗，改善治疗将提高可手术肺癌患者的治愈率