Quantitative Analysis of Response to Treatment with Erlotinib in Advanced Non–Small Cell Lung Cancer Using 18F-FDG and 3′-Deoxy-3′-18F-Fluorothymidine PET

• DOI: 10.2967/jnumed.111.094458
• Publication Date: 2011-11-08T03:55:11Z
• Authors: Deniz Kahraman; Matthias Scheffler; Thomas Zander; Lucia Nogova; Adriaan A. Lammer...; Ronald Boellaard; Bernd Neumaier; Roland T. Ullrich; Arne Holstein; Markus Dietlein; Jürgen Wolf; Carsten Kobe
• Keywords: Standardized uptake value

The purpose of this study was to evaluate the relevance for prediction clinical benefit first-line treatment with erlotinib using different quantitative parameters PET both ¹⁸F-FDG and 3′-deoxy-3′-¹⁸F-fluorothymidine (¹⁸F-FLT) in patients advanced non–small cell lung cancer. <b>Methods:</b> Data were used from a prospective trial involving untreated stage IV ¹⁸F-FLT performed before 1 (early) 6 (late) weeks after treatment. Several standardized uptake values (SUVs) definitions volumes interest varying isocontours (maximum SUV [SUV_max], 2-dimensional peak [SUV_2Dpeak], 3-dimensional [3D] [SUV_3Dpeak], 3D isocontour at 50% maximum pixel value [SUV₅₀], adapted background [SUV_A50], 41% [SUV_A41], 70% [SUV₇₀], [SUV_A70], relative threshold level [SUV_RTL]) metabolically active volume measurements obtained hottest single tumor lesion sum up 5 lesions per scan 30 patients. Metabolic response defined as minimum reduction 30% each SUVs 45% volume. Progression-free survival (PFS) compared between without metabolic measured parameters, Kaplan–Meier statistics log-rank test. <b>Results:</b> Patients on early well had significantly longer PFS, regardless method calculate SUV. However, highest significance SUV_max, SUV₅₀, SUV_A50, SUV_A41. by SUV_max SUV_3Dpeak late PFS. Furthermore, analyses showed strong association PFS seen volume, either or ¹⁸F-FDG. <b>Conclusion:</b> Early can predict calculation. SUV_A41 might be best robust use prediction. Metabolically measurement may have an additional predictive monitoring cancer treated erlotinib.