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Predictive and prognostic value of early response assessment using 18FDG-PET in advanced non-small cell lung cancer patients treated with erlotinib

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Abstract

Background

[18F]fluorodeoxyglucose (FDG)-PET is being evaluated as a tool for the early detection of response to various targeted agents in solid tumors. The aim of this study was to evaluate the predictive value of PET response after 2 days of erlotinib in unselected pretrated patients with stage IV NSCLC.

Patients and methods

FDG-PET/CT scans were conducted at baseline and after 2 days of erlotinib, with a CT evaluation performed at baseline and after 45–60 days of therapy. PET responses were evaluated by quantitative changes on SUVmax tumor/non-tumor ratio and classified according to EORTC criteria. PET responses were compared with RECIST responses and related to progression-free (PFS) and overall (OS) survival. Erlotinib effects on glucose uptake were also studied in a panel of NSCLC cell lines.

Results

Fifty-three patients were enrolled. At 2 days of erlotinib, 20 (38 %) patients showed partial metabolic response (PMR), 25 (47 %) had stable metabolic disease (SMD) and 8 (15 %) had progressive metabolic disease (PMD). All patients with PMD had confirmed RECIST progression at 45–60 days. Patients with early PMR and SMD had significantly longer PFS (p < 0.001 and p = 0.001, respectively) and OS (p = 0.001 for both) than PMD patients.

Conclusions

FDG-PET assessment after 2 days of erlotinib could be useful to identify early resistent patients and to predict survival in unselected NSCLC pretreated population.

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Acknowledgments

This work was supported by: Associazione Italiana per la Ricerca sul Cancro (AIRC), Milan Grant IG 8856.

Conflict of interest

No authors have conflict of interest to declare.

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Authors and Affiliations

  1. Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100, Parma, Italy

    Marcello Tiseo, Marco Bartolotti, Beatrice Bortesi & Andrea Ardizzoni

  2. Medicina Nucleare, Ospedale Cannizzaro Catania, Catania, Italy

    Massimo Ippolito & Sebastiano Cosentino

  3. Medicina Nucleare, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    Maura Scarlattei & Livia Ruffini

  4. Oncologia Medica, Clinica Villa Salus, Messina, Italy

    Pietro Spadaro

  5. Oncologia Medica, Ospedale Garibaldi, Catania, Italy

    Fiorenza Latteri, Roberto Bordonaro & Hector J. Soto Parra

  6. Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Parma, Italy

    Claudia Fumarola, Cristina Caffarra, Andrea Cavazzoni, Roberta R. Alfieri & Pier Giorgio Petronini

  7. Epidemiologia Clinica, IRCCS San Martino, Istituto Nazionale per la Ricerca sul Cancro di Genova, Genoa, Italy

    Paolo Bruzzi

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  1. Marcello Tiseo
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Correspondence to Marcello Tiseo or Andrea Ardizzoni.

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Tiseo, M., Ippolito, M., Scarlattei, M. et al. Predictive and prognostic value of early response assessment using 18FDG-PET in advanced non-small cell lung cancer patients treated with erlotinib. Cancer Chemother Pharmacol 73, 299–307 (2014). https://doi.org/10.1007/s00280-013-2356-x

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