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

与细胞毒性化疗相比，分子靶向治疗具有优势，因为它对靶细胞具有特异性。治疗效果被认为降低了恶性细胞的葡萄糖代谢，使[18F]氟代脱氧葡萄糖(F-FDG)的摄取率降低。胃肠道间质瘤(GIST)的恶性潜能在手术前不易评估。病理分析表明，肿瘤摄取~(18)F-FDG与切除肿瘤的细胞增殖率有关。这些结果表明，18F-FDGPET对GIST的恶性程度有一定的评估作用。甲磺酸伊马替尼对18F-FDG摄取的减少与甲磺酸伊马替尼的疗效比较正在研究中。抗CD20单抗对恶性淋巴瘤有效。18F-FDGPET对恶性淋巴瘤的分期、抗肿瘤疗效及预后评估有重要价值。在接受有效治疗的患者中，即使CT显示肿瘤残留，18F-FDGPET的摄取率也会下降。这些结果表明，与CT的标准方法相比，18F-FDGPET在准确评估疗效方面具有替代作用。伴有表皮生长因子受体(EGFR)突变的支气管腺癌对吉非替尼治疗的疗效有很高的预测性。18&gt；F-FDGPET在评估EGFR突变肺癌患者对吉非替尼的疗效方面的临床试验正在进行中。

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.