Predictive and prognostic value of early response assessment using 18FDG-PET in advanced non-small cell lung cancer patients treated with erlotinib

Marcello Tiseo, Massimo Ippolito, Maura Scarlattei, Pietro Spadaro, Sebastiano Cosentino, Fiorenza Latteri, Livia Ruffini, Marco Bartolotti, Beatrice Bortesi, Claudia Fumarola, Cristina Caffarra, Andrea Cavazzoni, Roberta R. Alfieri, Pier Giorgio Petronini, Roberto Bordonaro, Paolo Bruzzi, Andrea Ardizzoni, Hector J. Soto Parra

Research output: Contribution to journalArticlepeer-review

Abstract

Background: [18F]fluorodeoxyglucose (FDG)-PET is being evaluated as a tool for the early detection of response to various targeted agents in solid tumors. The aim of this study was to evaluate the predictive value of PET response after 2 days of erlotinib in unselected pretrated patients with stage IV NSCLC. Patients and methods: FDG-PET/CT scans were conducted at baseline and after 2 days of erlotinib, with a CT evaluation performed at baseline and after 45-60 days of therapy. PET responses were evaluated by quantitative changes on SUVmax tumor/non-tumor ratio and classified according to EORTC criteria. PET responses were compared with RECIST responses and related to progression-free (PFS) and overall (OS) survival. Erlotinib effects on glucose uptake were also studied in a panel of NSCLC cell lines. Results: Fifty-three patients were enrolled. At 2 days of erlotinib, 20 (38 %) patients showed partial metabolic response (PMR), 25 (47 %) had stable metabolic disease (SMD) and 8 (15 %) had progressive metabolic disease (PMD). All patients with PMD had confirmed RECIST progression at 45-60 days. Patients with early PMR and SMD had significantly longer PFS (p <0.001 and p = 0.001, respectively) and OS (p = 0.001 for both) than PMD patients. Conclusions: FDG-PET assessment after 2 days of erlotinib could be useful to identify early resistent patients and to predict survival in unselected NSCLC pretreated population.

Original languageEnglish
Pages (from-to)299-307
Number of pages9
JournalCancer Chemotherapy and Pharmacology
Volume73
Issue number2
DOIs
Publication statusPublished - 2014

Keywords

  • 18FDG-PET
  • Erlotinib
  • Metabolic response
  • NSCLC

ASJC Scopus subject areas

  • Toxicology
  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)

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