A phase II study of 18F-fluorodeoxyglucose PET–CT in non-small cell lung cancer patients receiving erlotinib (Tarceva®); objective and symptomatic responses at 6 and 12weeks

O’Brien, M.; Myerson, James S.; Coward, Jermaine; Puglisi, Martina; Trani, Leonardo; Wotherspoon, Andrew; Sharma, Bhupinder; Cook, Gary; Ashley, S.; Gunapala, R.; Chua, Sue; Popat, Sanjay

doi:10.1016/j.ejca.2011.10.033

Cited by 25 publications

(19 citation statements)

References 15 publications

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“…Several other investigations have demonstrated the value of early metabolic monitoring (days 7-14) for predicting progression-free survival and overall survival in advanced-stage disease. Our data are in line with those of Zander et al (19) and O'Brien et al (26), who showed that early monitoring can predict the metabolic response at a later scan after erlotinib treatment in patients with advanced NSCLC.…”

Section: Discussionsupporting

confidence: 81%

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

et al. 2014

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The purpose of this study was to prospectively evaluate the timing of metabolic response monitoring with 18 F-FDG PET of (neoadjuvant) erlotinib treatment in patients with early-stage non-small cell lung cancer. Methods: This study was designed as an open-label phase II trial performed in 4 hospitals in The Netherlands. Patients received preoperative erlotinib (150 mg) once daily for 3 wk. Response evaluation was performed after 4-7 d and at 3 wk with 18 F-FDG PET/CT scans. Tumor 18 F-FDG uptake and changes were measured as standardized uptake values (SUVs). The metabolic response was classified on the basis of European Organization for Research and Treatment of Cancer criteria (.25% decrease in the maximum SUV) and was compared with histopathologic regression as observed in the resection specimen. Results: From December 2006 to November 2010, 60 patients with non-small cell lung cancer eligible for surgical resection were enrolled in this study. For 43 patients (18 men and 25 women), baseline 18 F-FDG PET/CT scans as well as both monitoring scans and histopathologic response monitoring were available. A partial metabolic response on 18 F-FDG PET/CT scans was observed for 10 patients (23%) after 1 wk and for 14 patients (33%) after 3 wk. Histopathologic examination revealed regression (necrosis of .50%) in 11 patients (26%). In these patients, the maximum SUV decreased by a mean of 17% within 1 wk and a mean of 31% at 3 wk. Seven patients were identified as responders within 1 wk. Conclusion: Response monitoring with 18 F-FDG PET/CT within 1 wk after the start of erlotinib treatment identified approximately 64% of histopathologic responders on the basis of European Organization for Research and Treatment of Cancer criteria.

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Section: Discussionsupporting

confidence: 81%

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

et al. 2014

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“…Because several papers addressing these issues have been published [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], we also performed a retrospective review of our cohort data. The first goal of the retrospective analysis was to investigate whether early FDG-PET assessment of treatment response using TLG-S would be superior to either local assessment with EORTC criteria or hottest-single-lesion assessment with PERCIST criteria for predicting 2-year survival outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have shown that FDG-PET is a useful imaging modality for predicting response to erlotinib in patients with non-small cell lung cancer (NSCLC) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. However, most of these studies used only the primary tumor as the target lesion for sequential imaging [3][4][5][6][7][8][9][10][11][12], and treatment response was largely assessed using the European Organization for Research and Treatment of Cancer (EORTC) criteria [3][4][5][6][7][8][9]20]. Other studies have evaluated treatment response using the Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) [21], based on the measurement of a specific focus on the hottest single lesion, including the metastatic tumor [15,16].…”

Section: Introductionmentioning

confidence: 99%

TLG-S criteria are superior to both EORTC and PERCIST for predicting outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib

Fang

Chung

et al. 2016

Eur J Nucl Med Mol Imaging

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“…In non-small cell lung cancer (NSCLC), several studies have shown the utility of serial 18 F-FDG PET/CT to measure response to neoadjuvant chemotherapy (1-6), chemoradiotherapy (7,8), or novel biologic therapies (9,10). There is also more limited evidence that the level of uptake on pretreatment scans, as measured by various standardized uptake value (SUV) parameters, may be predictive (11)(12)(13)(14), but results conflict as to whether high or low SUVs are predictive depending on treatment modality (13,14).…”

mentioning

confidence: 99%

Are Pretreatment ¹⁸F-FDG PET Tumor Textural Features in Non–Small Cell Lung Cancer Associated with Response and Survival After Chemoradiotherapy?

et al. 2012

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There is evidence in some solid tumors that textural features of tumoral uptake in 18 F-FDG PET images are associated with response to chemoradiotherapy and survival. We have investigated whether a similar relationship exists in non-small cell lung cancer (NSCLC). Methods: Fifty-three patients (mean age, 65.8 y; 31 men, 22 women) with NSCLC treated with chemoradiotherapy underwent pretreatment 18 F-FDG PET/CT scans. Response was assessed by CT Response Evaluation Criteria in Solid Tumors (RECIST) at 12 wk. Overall survival (OS), progression-free survival (PFS), and local PFS (LPFS) were recorded. Primary tumor texture was measured by the parameters coarseness, contrast, busyness, and complexity. The following parameters were also derived from the PET data: primary tumor standardized uptake values (SUVs) (mean SUV, maximum SUV, and peak SUV), metabolic tumor volume, and total lesion glycolysis. Results: Compared with nonresponders, RECIST responders showed lower coarseness (mean, 0.012 vs. 0.027; P 5 0.004) and higher contrast (mean, 0.11 vs. 0.044; P 5 0.002) and busyness (mean, 0.76 vs. 0.37; P 5 0.027). Neither complexity nor any of the SUV parameters predicted RECIST response. By Kaplan-Meier analysis, OS, PFS, and LPFS were lower in patients with high primary tumor coarseness (median, 21.1 mo vs. not reached, P 5 0.003; 12.6 vs. 25.8 mo, P 5 0.002; and 12.9 vs. 20.5 mo, P 5 0.016, respectively). Tumor coarseness was an independent predictor of OS on multivariable analysis. Contrast and busyness did not show significant associations with OS (P 5 0.075 and 0.059, respectively), but PFS and LPFS were longer in patients with high levels of each (for contrast: median of 20.5 vs. 12.6 mo, P 5 0.015, and median not reached vs. 24 mo, P 5 0.02; and for busyness: median of 20.5 vs. 12.6 mo, P 5 0.01, and median not reached vs. 24 mo, P 5 0.006). Neither complexity nor any of the SUV parameters showed significant associations with the survival parameters. Conclusion: In NSCLC, baseline 18 F-FDG PET scan uptake showing abnormal texture as measured by coarseness, contrast, and busyness is associated with nonresponse to chemoradiotherapy by RECIST and with poorer prognosis. Measurement of tumor metabolic heterogeneity with these parameters may provide indices that can be used to stratify patients in clinical trials for lung cancer chemoradiotherapy.

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A phase II study of 18F-fluorodeoxyglucose PET–CT in non-small cell lung cancer patients receiving erlotinib (Tarceva®); objective and symptomatic responses at 6 and 12weeks

Cited by 25 publications

References 15 publications

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

TLG-S criteria are superior to both EORTC and PERCIST for predicting outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib

Are Pretreatment ¹⁸F-FDG PET Tumor Textural Features in Non–Small Cell Lung Cancer Associated with Response and Survival After Chemoradiotherapy?

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A phase II study of 18F-fluorodeoxyglucose PET–CT in non-small cell lung cancer patients receiving erlotinib (Tarceva®); objective and symptomatic responses at 6 and 12weeks

Cited by 25 publications

References 15 publications

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

TLG-S criteria are superior to both EORTC and PERCIST for predicting outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib

Are Pretreatment 18F-FDG PET Tumor Textural Features in Non–Small Cell Lung Cancer Associated with Response and Survival After Chemoradiotherapy?

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Are Pretreatment ¹⁸F-FDG PET Tumor Textural Features in Non–Small Cell Lung Cancer Associated with Response and Survival After Chemoradiotherapy?