Predictive value of positron emission tomography for the prognosis of molecularly targeted therapy in solid tumors

Abstract

ObjectiveThis study aimed at comprehensively exploring the value applying positron emission tomography (PET) to predict the effect of molecularly targeted therapy in solid tumors.Materials and methodsA systematic search was performed for potentially relevant studies from the time of inception to February 2017. The primary endpoints were progression-free survival (PFS), overall survival (OS), and time to progression (TTP). The results were analyzed by Review Manager version 5.3 (RevMan 5.3) statistical software. Subgroup analyses were implemented based on the type of molecularly targeted agents (monoclonal antibodies arm and small molecular targeted agents arm), mechanism (erlotinib/gefitinib arm and bevacizumab arm), radioactive tracers, type of tumor, and reevaluated PET timing.ResultsTwenty-six studies incorporating 865 individuals were eligible. Compared with PET nonresponse group, PET response group displayed a decrease in maximal standard uptake value (SUVmax), which was associated with a significantly prolonged PFS (HR =0.41, 95% CI [0.29, 0.59]; P<0.00001), OS (HR =0.52, 95% CI [0.40, 0.67]; P<0.00001), and TTP (HR =0.30, 95% CI [0.14, 0.66]; P=0.003). Similar results were obtained in the subgroup analyses of PFS in erlotinib/gefitinib arm and small molecular targeted agents arm; and OS in lung cancer arm, erlotinib/gefitinib arm, bevacizumab arm, small molecular targeted agents arm, monoclonal antibodies arm, 18F-fluorodeoxythymidine (18F-FLT) arm, 18F-fluorodeoxyglucose (18F-FDG) arm, and early PET timing arm.ConclusionOur study demonstrated that PET was a favorable approach to predict the prognosis of molecularly targeted therapy for solid tumors. PET assessment within 2 weeks could be useful to predict clinical outcome.

Molecular and functional imaging in cancer-targeted therapy: current applications and future directions

“…9, 4664 (2018)) gefitinib, [272][273][274][275] the antiangiogenic agent bevacizumab, 202,[276][277][278] HER2-targeted therapy with trastuzumab, 279 multiple TKIs such as regorafenib, 280,281 the CDK4/6 kinase inhibitors ribociclib, palbociclib, and abemcaciclib, 203,282,283 and the mTOR inhibitor everolimus, 204,284 as well as the ICIs nivolumab and pembrolizumab. 285,286 In a meta-analysis, 287 865 participants from 26 studies receiving inspection of FDG-PET or FLT-PET were included. In comparison with the PET nonresponsive group, the PET responsive group showed a decline in SUV max , which was related to prolonged PFS (HR = 0.41, P < 0.00001), OS (HR = 0.52, P < 0.00001), and time to progression (TTP) (HR = 0.30, P = 0.003).…”

Early Response Assessment to Targeted Therapy Using 3′-deoxy-3′[(18)F]-Fluorothymidine (18F-FLT) PET/CT in Lung Cancer

“…18 F-fluorothymidine, [ 18 F]3-deoxy-3-fluorothymidine ( 18 F-FLT), is an imaging biomarker of cellular proliferation and has been utilized in various cancer types including blood (lymphoma and leukemia), breast, head and neck, esophageal, and lung cancers as well as in bone and soft tissue sarcomas [1][2][3][4][5]. 18 F-FLT is derived from the cytostatic drug azidovudine developed for positron emission tomography (PET) imaging [6].…”