Hepatic Metastases of Gastric Adenocarcinoma Showing Metabolic Remission on FDG-PET Despite an Increase in Size on CT

Yoon, So Young; Kim, Sung-Yong; Cho, Yo-Han; Chung, Hyun Woo; So, Young; Lee, Hong M

doi:10.4143/crt.2009.41.2.100

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…Dose selection and schedule could also be explored further. On the intermittent schedule used in this and other studies of sunitinib, pharmacodynamic modulation of several plasma proteins associated with angiogenesis was reversible during the off-treatment period [ 38 , 43 – 45 ]. This raises the question of whether continuous administration of sunitinib might be of benefit, to ensure continuous suppression of angiogenesis.…”

Section: Discussionmentioning

confidence: 98%

Phase II study of sunitinib as second-line treatment for advanced gastric cancer

et al. 2010

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SummaryPurpose. This phase II, open-label, multicenter study assessed the oral, multitargeted, tyrosine kinase inhibitor sunitinib in patients with advanced gastric or gastroesophageal junction adenocarcinoma who had received prior chemotherapy. Experimental design. Patients received sunitinib 50 mg/day on Schedule 4/2 (4 weeks on treatment, followed by 2 weeks off treatment). The primary endpoint was objective response rate; secondary endpoints included clinical benefit rate, duration of response, progression-free survival (PFS), overall survival (OS), pharmacokinetics, pharmacodynamics, safety and tolerability, and quality of life. Results. Of 78 patients enrolled, most had gastric adenocarcinoma (93.6%) and metastatic disease (93.6%). All were evaluable for safety and efficacy. Two patients (2.6%) had partial responses and 25 patients (32.1%) had a best response of stable disease for ≥6 weeks. Median PFS was 2.3 months (95% confidence interval [CI], 1.6–2.6 months) and median OS was 6.8 months (95% CI, 4.4–9.6 months). Grade ≥3 thrombocytopenia and neutropenia were reported in 34.6% and 29.4% of patients, respectively, and the most common non-hematologic adverse events were fatigue, anorexia, nausea, diarrhea, and stomatitis. Pharmacokinetics of sunitinib and its active metabolite were consistent with previous reports. There were no marked associations between baseline soluble protein levels, or changes from baseline, and measures of clinical outcome. Conclusions. The progression-delaying effect and manageable toxicity observed with sunitinib in this study suggest that although single-agent sunitinib has insufficient clinical value as second-line treatment for advanced gastric cancer, its role in combination with chemotherapy merits further study.

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Section: Discussionmentioning

confidence: 98%

Phase II study of sunitinib as second-line treatment for advanced gastric cancer

et al. 2010

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“…One study reported a case with hepatic metastatic lesions that showed metabolic remission on 18 F-fluorodeoxyglucose PET after treatment with combination chemotherapeutic agents including oxaliplatin, 5-fluorouracil, and leucovorin (modified FOLFOX-6 regimen); however, the patient did not achieve CR and the remission duration was 12 months. 12 In our case, a liver biopsy was not performed. However, when the patient was diagnosed with liver metastasis based on the CT images, there was no evidence of infection (body temperature 36.7℃, C-reactive protein 0.08 mg/dl) such as liver abscess.…”

Section: Discussionmentioning

confidence: 78%

A Case of Long-Term Complete Remission of Advanced Gastric Adenocarcinoma with Liver Metastasis

et al. 2016

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We report the case of a patient with gastric adenocarcinoma with multiple liver metastases. This patient showed complete remission for more than 68 months after S-1/cisplatin combination chemotherapy and radical total gastrectomy. The patient, a 63-year-old man, presented with dyspepsia and difficulty in swallowing. Endoscopic findings showed a huge ulcero-infiltrative mass at the lesser curvature of the mid-body, extending to the distal esophagus. Biopsy revealed a poorly differentiated tubular adenocarcinoma. An abdominal computed tomography scan demonstrated multiple hepatic metastases. S-1/cisplatin combination chemotherapy was initiated, and following completion of six cycles of chemotherapy, the gastric masses and hepatic metastatic lesions had disappeared on abdominal computed tomography. Radical total gastrectomy and D2 lymphadenectomy combined with splenectomy were performed. The patient underwent three cycles of S-1/cisplatin combination chemotherapy followed by tegafur-uracil therapy for 1 year. He remained in complete remission for more than 68 months after surgery.

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“…These alterations do occur before tumor shrinkage. Indeed, metabolic changes may be particularly useful when sorafenib‐induced central necrosis and edema make Response Evaluation Criteria in Solid Tumors (RECIST)‐defined responses difficult to be measured . Such early metabolic response evaluation might be very useful in clinical practice as a tool for rapid response prediction.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, metabolic changes may be particularly useful when sorafenib-induced central necrosis and edema make Response Evaluation Criteria in Solid Tumors (RECIST)-defined responses difficult to be measured. 28,29 Such early metabolic response evaluation might be very useful in clinical practice as a tool for rapid response prediction. No primary data are yet available on the use of 18 FDG PET-CT to test sorafenib efficacy as a predictive factor for clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Phase II trial evaluating the efficacy of sorafenib (BAY 43‐9006) and correlating early fluorodeoxyglucose positron emission tomography–CT response to outcome in patients with recurrent and/or metastatic head and neck cancer

et al. 2015

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Hepatic Metastases of Gastric Adenocarcinoma Showing Metabolic Remission on FDG-PET Despite an Increase in Size on CT

Cited by 5 publications

References 7 publications

Phase II study of sunitinib as second-line treatment for advanced gastric cancer

Phase II study of sunitinib as second-line treatment for advanced gastric cancer

A Case of Long-Term Complete Remission of Advanced Gastric Adenocarcinoma with Liver Metastasis

Phase II trial evaluating the efficacy of sorafenib (BAY 43‐9006) and correlating early fluorodeoxyglucose positron emission tomography–CT response to outcome in patients with recurrent and/or metastatic head and neck cancer

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