Abstract
Object
This pilot study evaluated the utility of 3′-deoxy-3′[18F]-fluorothymidine ([18F]-FLT) positron emission tomography (PET) to predict response to neoadjuvant therapy that included cetuximab in patients with wild-type KRAS rectal cancers.
Methods
Baseline [18F]-FLT PET was collected prior to treatment initiation. Follow-up [18F]-FLT was collected after three weekly infusions of cetuximab, and following a combined regimen of cetuximab, 5-FU, and radiation. Imaging-matched biopsies were collected with each PET study.
Results
Diminished [18F]-FLT PET was observed in 3/4 of patients following cetuximab treatment alone and in all patients following combination therapy. Reduced [18F]-FLT PET following combination therapy predicted disease-free status at surgery. Overall, [18F]-FLT PET agreed with Ki67 immunoreactivity from biopsy samples and surgically resected tissue, and was predictive of treatment-induced rise in p27 levels.
Conclusion
These results suggest that [18F]-FLT PET is a promising imaging biomarker to predict response to neoadjuvant therapy that included EGFR blockade with cetuximab in patients with rectal cancer.
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Acknowledgments
The authors acknowledge funding from the National Institutes of Health (R25 CA136440, R25 CA092043, K25 CA127349, P50 CA128323, P50 CA095103, R01 CA140628, RC1 CA145138, P30 DK058404, P50 CA127003, UL1 TR000445), the Kleberg Foundation, and Bristol Meyers Squib. The authors acknowledge Frank Revetta for assistance with immunohistochemistry.
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McKinley, E.T., Watchmaker, J.M., Bapsi Chakravarthy, A. et al. [18F]-FLT PET to predict early response to neoadjuvant therapy in KRAS wild-type rectal cancer: a pilot study. Ann Nucl Med 29, 535–542 (2015). https://doi.org/10.1007/s12149-015-0974-6
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DOI: https://doi.org/10.1007/s12149-015-0974-6