A phase II study of F-18-fluorodeoxyglucose PET-CT in non-small cell lung cancer patients receiving erlotinib (Tarceva (R)); objective and symptomatic responses at 6 and 12 weeks

作者：O'Brien M E R; Myerson J S; Coward J I G^*; Puglisi M; Trani L; Wotherspoon A; Sharma B; Cook G; Ashley S; Gunapala R; Chua S; Popat S

来源：European Journal of Cancer, 2012, 48(1): 68-74.

DOI：10.1016/j.ejca.2011.10.033

• FDG-PET-CT
• Erlotinib
• NSCLC
• Progressive disease
• Symptomatic response

Background: The aim of this study was to assess if F-18-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)-CT scanning could minimise the time non-responding patients were exposed to erlotinib (Tarceva (R)).
Methods: Patients were selected for clinical factors that would predict response to erlotinib. A FDG PET-CT and diagnostic contrast-enhanced (traditional) CT scan were carried out at baseline, and then a FDG PET-CT at 6 weeks and a traditional CT at 12 weeks were repeated. The primary end-point was rate of early progression in patients after 6 weeks, of which a minimum 12 out of 35 were required to make the study worthwhile. The responses at 6 (PET-CT) and 12 weeks (traditional CT) were compared and correlated with symptomatic response at both these time points.
Results: Forty seven patients were recruited with 38 and 33 patients assessable by FDG PET-CT at 6 weeks and traditional CT at 12 weeks, respectively. There was good correlation between Partial response (PR) at both time points and all 10 patients who had a PR at 12 weeks had a PR at 6 weeks. Of the 13 patients with progressive disease (PD) at 12 weeks, seven had PD at 6 weeks and could have had their treatment stopped early. No evaluable patient with stable disease (SD) (8/38) or PD (9/38) on FDG PET-CT at 6 weeks went on to have a later response. Symptomatic response at 6 or 12 weeks did not correlate well with objective response on scanning at either time point.
Conclusions: The primary end-point of this study was met as >12 (15/38) patients could have stopped treatment early on the basis of the FDG PET-CT scan result. A FDG PET-CT evaluable response of SD or PD at 6 weeks does predict future lack of response. No correlation was found between response and symptomatic response at either 6 or 12 weeks.

• 出版日期2012-1