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Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

  • Yifei Ma
  • Wei Xu
  • Ruojing Bai
  • Yiming Li
  • Hongyu YuEmail author
  • Chunshan Yang
  • Huazheng Shi
  • Jian Zhang
  • Jidong Li
  • Chenguang Wang
  • Jianru XiaoEmail author
Original Article

Abstract

Purpose

To test the performance of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP).

Methods

CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy.

Results

Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method.

Conclusion

Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome.

Keywords

Volume-based PET/CT parameters Survival prediction Sunitinib Cancer of unknown primary 

Notes

Compliance with ethical standards

Funding

This study was supported by the joint taking program of key disease (Grant 2014ZYJB0103) and the Shanghai Youth Science and Technology Talent Sailing Program (Grant 14YF1405900).

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

All patients gave informed consent to the treatment, PET/CT scanning and participation in study.

Supplementary material

259_2016_3504_MOESM1_ESM.docx (67 kb)
ESM 1 (DOCX 67.4 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yifei Ma
    • 1
    • 2
  • Wei Xu
    • 1
  • Ruojing Bai
    • 3
  • Yiming Li
    • 4
  • Hongyu Yu
    • 2
    Email author
  • Chunshan Yang
    • 5
    • 6
  • Huazheng Shi
    • 6
  • Jian Zhang
    • 6
  • Jidong Li
    • 7
  • Chenguang Wang
    • 8
  • Jianru Xiao
    • 1
    Email author
  1. 1.Department of Orthorpedic Oncology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  2. 2.Department of Pathology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina
  3. 3.Department of Geriatrics, Tianjin Medical University General Hospital, Laboratory of Neuro-Trauma and Neurodegenerative DisorderGeriatrics InstituteTianjinChina
  4. 4.Department of Neuro-oncologyNeurosurgery InstituteBeijingChina
  5. 5.Department of PET/CT RadiologyPanorama Medical Imaging CenterShanghaiChina
  6. 6.Department of PET/CT Radiology CenterShanghaiChina
  7. 7.Department of StomatologyThe First People’s Hospital of ShangqiuShangqiuChina
  8. 8.Department of Radiology, Changzheng HospitalSecond Military Medical UniversityShanghaiChina

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