Skip to main content
SpringerLink
Log in

The Role of 18F-FDG-PET as Therapeutic Monitoring in Patients with Lung Cancer

  • Chapter
  • First Online:
Applications of FDG PET in Oncology

  • 386 Accesses

Abstract

While 2′-deoxy-2′-[(18)F] fluoro-D-glucose (18F-FDG) positron emission tomography (PET) could be useful for cancer diagnosis, recent approaches have focused only on therapeutic monitoring. This study reviewed and discussed the role of therapeutic monitoring of molecular target agents, angiogenetic inhibitors, and immune checkpoint inhibitors (ICIs) in patients with lung cancer. ICIs including anti-programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) antibodies are extensively administered to patients with advanced or metastatic non-small cell lung cancer (NSCLC); however, an established modality to predict the efficacy of this treatment in early stages remains unclear. Recently, preliminary data suggested that changes in 18F-FDG uptake at 1 month after initiation of nivolumab was closely associated with an early response to ICI in patients with advanced NSCLC. Moreover, the close relationship between 18F-FDG uptake and PD-L1 expression has also been investigated in different kinds of institutions, with similar results.

18F-FDG-PET is a useful modality for cancer diagnosis, with an expanding role to therapeutic monitoring of cancer chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Maemondo M, Inoue A, Kobayashi K, Sugawara S, Oizumi S, Isobe H, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362:2380–8.

    Article  CAS  Google Scholar 

  2. Kwak EL, Bang YJ, Camidge DR, Shaw AT, Solomon B, Maki RG, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med. 2010;363:1693–703.

    Article  CAS  Google Scholar 

  3. Yang JC, Wu YL, Schuler M, Sebastian M, Popat S, Yamamoto N, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol. 2015;16:141–51.

    Article  CAS  Google Scholar 

  4. Soria JC, Ohe Y, Vansteenkiste J, Reungwetwattana T, Chewaskulyong B, Lee KH, et al. Osimertinib in untreated EGFR-mutated advanced non-small-cell lung cancer. N Engl J Med. 2018;378:113–25.

    Article  CAS  Google Scholar 

  5. Borghaei H, Paz-Ares L, Horn L, Spigel DR, Steins M, Ready NE, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med. 2015;373:1627–39.

    Article  CAS  Google Scholar 

  6. Robert C, Long GV, Brady B, Dutriaux C, Maio M, Mortier L, et al. Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 2015;372:320–30.

    Article  CAS  Google Scholar 

  7. Motzer RJ, Escudier B, McDermott DF, George S, Hammers HJ, Srinivas S, et al. nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med. 2015;373:1803–13.

    Article  CAS  Google Scholar 

  8. Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, et al. Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N Engl J Med. 2016;375:1823–33.

    Article  CAS  Google Scholar 

  9. Rittmeyer A, Barlesi F, Waterkamp D, Park K, Ciardiello F, von Pawel J, et al. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet. 2017;389:255–65.

    Article  Google Scholar 

  10. Lee DH, Kim SK, Lee HY, Lee SY, Park SH, Kim HY, et al. Early prediction of response to first-line therapy using integrated 18F-FDG PET/CT for patients with advanced/metastatic non-small cell lung cancer. J Thorac Oncol. 2009;4:816–21.

    Article  Google Scholar 

  11. Sunaga N, Oriuchi N, Kaira K, Yanagitani N, Tomizawa Y, Hisada T, et al. Usefulness of FDG-PET for early prediction of the response to gefitinib in non-small cell lung cancer. Lung Cancer. 2008;59:203–10.

    Article  Google Scholar 

  12. Zander T, Scheffler M, Nogova L, Kobe C, Engel-Riedel W, Hellmich M, et al. Early prediction of nonprogression in advanced non-small-cell lung cancer treated with erlotinib by using [(18)F]fluorodeoxyglucose and [(18)F]fluorothymidine positron emission tomography. J Clin Oncol. 2011;29:1701–8.

    Article  CAS  Google Scholar 

  13. Benz MR, Herrmann K, Walter F, Garon EB, Reckamp KL, Figlin R, et al. (18)F-FDG PET/CT for monitoring treatment responses to the epidermal growth factor receptor inhibitor erlotinib. J Nucl Med. 2011;52:1684–9.

    Article  CAS  Google Scholar 

  14. Niho S, Kunitoh H, Nokihara H, Horai T, Ichinose Y, Hida T, et al. Randomized phase II study of first-line carboplatin-paclitaxel with or without bevacizumab in Japanese patients with advanced non-squamous non-small-cell lung cancer. Lung Cancer. 2012;76:362–7.

    Article  Google Scholar 

  15. Dingemans AM, de Langen AJ, van den Boogaart V, Marcus JT, Backes WH, Scholtens HT, et al. First-line erlotinib and bevacizumab in patients with locally advanced and/or metastatic non-small-cell lung cancer: a phase II study including molecular imaging. Ann Oncol. 2011;22:559–66.

    Article  Google Scholar 

  16. de Jong EE, van Elmpt W, Leijenaar RT, Hoekstra OS, Groen HJ, Smit EF, et al. [18F]FDG PET/CT-based response assessment of stage IV non-small cell lung cancer treated with paclitaxel-carboplatin-bevacizumab with or without nitroglycerin patches. Eur J Nucl Med Mol Imaging. 2017;44:8–16.

    Article  Google Scholar 

  17. Kaira K, Endo M, Abe M, Nakagawa K, Ohde Y, Okumura T, et al. Biologic correlates of 18F-FDG uptake on PET in pulmonary pleomorphic carcinoma. Lung Cancer. 2011;71:144–50.

    Article  Google Scholar 

  18. Brahmer J, Reckamp KL, Baas P, Crinò L, Eberhardt WE, Poddubskaya E, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med. 2015;373:123–35.

    Article  CAS  Google Scholar 

  19. Kaira K, Higuchi T, Naruse I, Arisaka Y, Tokue A, Altan B, et al. Metabolic activity by 18F-FDG-PET/CT is predictive of early response after nivolumab in previously treated NSCLC. Eur J Nucl Med Mol Imaging. 2018;45:56–66.

    Article  CAS  Google Scholar 

  20. Jreige M, Letovanec I, Chaba K, Renaud S, Rusakiewicz S, Cristina V, et al. 18F-FDG PET metabolic-to-morphological volume ratio predicts PD-L1 tumour expression and response to PD-1 blockade in non-small-cell lung cancer. Eur J Nucl Med Mol Imaging. 2019;46:1859–68.

    Article  CAS  Google Scholar 

  21. Kaira K, Endo M, Abe M, Nakagawa K, Ohde Y, Okumura T, et al. Biologic correlation of 2-[18F]-fluoro-2-deoxy-D-glucose uptake on positron emission tomography in thymic epithelial tumors. J Clin Oncol. 2010;28:3746–53.

    Article  CAS  Google Scholar 

  22. Chang YL, Yang CY, Lin MW, Wu CT, Yang PC. High co-expression of PD-L1 and HIF-1α correlates with tumour necrosis in pulmonary pleomorphic carcinoma. Eur J Cancer. 2016;60:125–35.

    Article  CAS  Google Scholar 

  23. Ruf M, Moch H, Schraml P. PD-L1 expression is regulated by hypoxia inducible factor in clear renal cell carcinoma. Int J Cancer. 2016;139:396–403.

    Article  CAS  Google Scholar 

  24. Takada K, Toyokawa G, Okamoto T, Baba S, Kozuma Y, Matsubara T, et al. Metabolic characteristics of programmed cell death-ligand 1-expressing lung cancer on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Cancer Med. 2017;6:2552–61.

    Article  CAS  Google Scholar 

  25. Zhang M, Wang D, Sun Q, Pu H, Wang Y, Zhao S, et al. Prognostic significance of PD-L1 expression and 18F-FDG PET/CT in surgical pulmonary squamous cell carcinoma. Oncotarget. 2017;8:51630–40.

    Article  Google Scholar 

  26. Kasahara N, Kaira K, Yamaguchi K, Masubuchi H, Tsurumaki H, Hara K, et al. Fluorodeoxyglucose uptake is associated with low tumor-infiltrating lymphocyte levels in patients with small cell lung cancer. Lung Cancer. 2019;134:180–6.

    Article  Google Scholar 

  27. Kaira K, Shimizu K, Kitahara S, Yajima T, Atsumi J, Kosaka T, et al. 2-Deoxy-2-[fluorine-18] fluoro-d-glucose uptake on positron emission tomography is associated with programmed death ligand-1 expression in patients with pulmonary adenocarcinoma. Eur J Cancer. 2018;101:181–90.

    Article  CAS  Google Scholar 

  28. Chen J, Jiang CC, Jin L, Zhang XD. Regulation of PD-1: a novel role of pro-survival signalling in cancer. Ann Oncol. 2016;27:409–16.

    Article  CAS  Google Scholar 

  29. Noman MZ, Desantis G, Janji B, Hasmim M, Karray S, Dessen P, et al. PD-L1 is a novel direct target of HIF-1α, and its blockade under hypoxia enhanced MDSC-mediated T cell activation. J Exp Med. 2014;211:781–90.

    Article  CAS  Google Scholar 

  30. Kaira K, Oriuchi N, Otani Y, Shimizu K, Tanaka S, Imai H, et al. Fluorine-18-alpha-methyltyrosine positron emission tomography for diagnosis and staging of lung cancer: a clinicopathologic study. Clin Cancer Res. 2007;13:6369–78.

    Article  CAS  Google Scholar 

  31. Nishii R, Higashi T, Kagawa S, Kishibe Y, Takahashi M, et al. Diagnostic usefulness of an amino acid tracer, α-[N-methyl-11C]-methylaminoisobutyric acid (11C-MeAIB), in the PET diagnosis of chest malignancies. Ann Nucl Med. 2013;27:808–21.

    Article  CAS  Google Scholar 

  32. Leskinen-Kallio S, Ruotsalainen U, Någren K, Teräs M, Joensuu H, et al. Uptake of carbon-11-methionine and fluorodeoxyglucose in non-Hodgkin’s lymphoma: a PET study. J Nucl Med. 1991;32:1211–8.

    CAS  PubMed  Google Scholar 

  33. Tomiyoshi K, Amed K, Muhammad S, Higuchi T, Inoue T, Endo K, et al. Synthesis of isomers of 18F-labelled amino acid radiopharmaceutical: position 2- and 3-L-18F-alpha-methyltyrosine using a separation and purification system. Nucl Med Commun. 1997;18:169–75.

    Article  CAS  Google Scholar 

  34. Kaira K, Oriuchi N, Shimizu K, Tominaga H, Yanagitani N, Sunaga N, et al. 18F-FMT uptake seen within primary cancer on PET helps predict outcome of non-small cell lung cancer. J Nucl Med. 2009;50:1770–6.

    Article  Google Scholar 

  35. Kaira K, Higuchi T, Sunaga N, Arisaka Y, Hisada T, Tominaga H, et al. Usefulness of 18F-α-methyltyrosine PET for therapeutic monitoring of patients with advanced lung cancer. Anticancer Res. 2016;36:6481–90.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, International Medical Center, Saitama Medical University, Hidaka-City, Saitama, Japan

    Kyoichi Kaira

Authors
  1. Kyoichi Kaira
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Functional Imaging, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan

    Hirofumi Fujii

  2. Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan

    Hiroyuki Nakamura

  3. Chairman of the board of trustee, Yotsuya Medical Cube, Tokyo, Japan

    Seiei Yasuda

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kaira, K. (2021). The Role of 18F-FDG-PET as Therapeutic Monitoring in Patients with Lung Cancer. In: Fujii, H., Nakamura, H., Yasuda, S. (eds) Applications of FDG PET in Oncology. Springer, Singapore. https://doi.org/10.1007/978-981-15-8423-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-15-8423-7_2

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-8422-0

  • Online ISBN: 978-981-15-8423-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation