Prospective Evaluation of FDG-PET/CT for On-treatment Assessment of Response to Neoadjuvant or Induction Chemotherapy in Invasive Bladder Cancer.

Autor:	Einerhand SMH; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands., Voskuilen CS; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands., van de Putte EEF; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands., Donswijk ML; Department of Nuclear Medicine, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Bruining A; Department of Radiology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van der Heijden MS; Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Mertens LS; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands., Hendricksen K; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands., Vegt E; Department of Nuclear Medicine, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Rhijn BWG; Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, TheNetherlands.; Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany.
Jazyk:	angličtina
Zdroj:	Bladder cancer (Amsterdam, Netherlands) [Bladder Cancer] 2023 Mar 31; Vol. 9 (1), pp. 49-57. Date of Electronic Publication: 2023 Mar 31 (Print Publication: 2023).
DOI:	10.3233/BLC-220036
Abstrakt:	Background: Neoadjuvant/induction chemotherapy (NAIC) improves survival in patients with muscle-invasive bladder carcinoma (MIBC). On-treatment response assessment may aid in decisions to continue or cease NAIC. Objective: We investigated whether ¹⁸ F-fluoro-2-deoxy-D-glucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could predict response to NAIC and compared to contrast-enhanced Computed Tomography (CECT). Methods: We prospectively included 83 patients treated for MIBC (i.e. high-risk cT2-4N0M0 or cT1-4N+M0-1a) between 2014 and 2018. Response to NAIC was assessed after 2-3 cycles with FDG-PET/CT (Peter-Mac and EORTC criteria) and CECT (RECIST1.1 criteria). We assessed prediction of complete pathological response (pCR; ypT0N0), complete pathological down-staging (pCD;≤ypT1N0), any down-staging from baseline (ypTN < cTN) and progression (inoperable tumor/ypN+/M+). The reference standard was histopathological assessment or clinical follow-up. Sensitivity, specificity, and accuracy were calculated. Results: Pathological response rates were 21% for pCR, 29% for pCD, and 10% progressed. All patients underwent FDG-PET/CT and 61 patients also underwent CECT (73%). Accuracy of FDG-PET/CT for prediction of pCR, pCD, and progression were 73%, 48%, and 73%, respectively. Accuracy of CECT for prediction of pCR, pCD, and progression were 78%, 65%, and 67%, respectively. Specificity of CECT was significantly higher than FDG-PET/CT for prediction of pCD and any down-staging ( p = 0.007 and p = 0.022). In all other analyses, no significant differences between FDG-PET/CT and CECT were found. Conclusions: Routine FDG-PET/CT has insufficient predictive power to aid in response assessment compared to CECT. Competing Interests: SMHE: none CSV: none EEFvdP: none MLD: none AB: none MSvdH: No conflicts of interest regarding the data presented in this manuscript. Other disclosures are research support from Bristol-Myers Squibb, AstraZeneca, 4SC and Roche and consultancy fees from Bristol-Myers Squibb, Merck, Merck Sharp & Dohme, Roche, AstraZeneca, Seattle Genetics, Pfizer and Janssen (all paid to the Netherlands Cancer Institute). LSM: none KH: none EV: none BWGvR: is an Editorial Board member of this journal, but was not involved in the peer-review process nor had access to any information regarding its peer-review. No conflicts of interest regarding the data presented in this manuscript. Other disclosures are Advisory Board meetings of QED Therapeutics and Ferring. (© 2023 – The authors. Published by IOS Press.)
Databáze:	MEDLINE
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