Monitoring metabolic response using FDG PET-CT during targeted therapy for metastatic colorectal cancer
| Autor: | Lieveke Ameye, Raphaël Maréchal, Amélie Deleporte, Irina Vierasu, Erwin Woff, Thomas Guiot, Camilo Garcia, Alain Hendlisz, Thierry Delaunoit, Gauthier Demolin, Namur Gauthier, Renaud Lhommel, Patrick Flamen, Marc Van den Eynde, Stéphane Holbrechts |
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| Přispěvatelé: | UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service de médecine nucléaire, UCL - (SLuc) Unité d'oncologie médicale, UCL - (SLuc) Centre du cancer |
| Rok vydání: | 2015 |
| Předmět: |
Oncology
Male Colorectal cancer medicine.medical_treatment Phenylurea Compounds -- administration & dosage 030218 nuclear medicine & medical imaging Targeted therapy Tumoral heterogeneity 0302 clinical medicine Positron Emission Tomography Computed Tomography Antineoplastic Combined Chemotherapy Protocols Radiopharmaceuticals -- pharmacokinetics Molecular Targeted Therapy Fluorodeoxyglucose F18 -- pharmacokinetics Imagerie médicale radiologie tomographie Metastatic colorectal cancer Colorectal Neoplasms -- diagnostic imaging -- drug therapy -- secondary General Medicine Middle Aged Sorafenib Treatment Outcome Drug Monitoring -- methods Radiology Nuclear Medicine and imaging 030220 oncology & carcinogenesis Fdg pet ct Female Original Article Niacinamide -- administration & dosage -- analogs & derivatives medicine.symptom Drug Monitoring Colorectal Neoplasms medicine.drug Adult Niacinamide medicine.medical_specialty Sensitivity and Specificity Capecitabine Lesion FDG PET-CT 03 medical and health sciences Fluorodeoxyglucose F18 Internal medicine medicine Volume reduction Humans Molecular Targeted Therapy -- methods Radiology Nuclear Medicine and imaging Aged business.industry Phenylurea Compounds Reproducibility of Results Positron Emission Tomography Computed Tomography -- methods medicine.disease Capecitabine -- administration & dosage Discontinuation Antineoplastic Combined Chemotherapy Protocols -- administration & dosage Radiopharmaceuticals business Early metabolic response assessment |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging European Journal of Nuclear Medicine and Molecular Imaging, Vol. 43, p. 1792-1801 (2016) European journal of nuclear medicine and molecular imaging, 43 (10 |
| ISSN: | 1619-7089 |
| Popis: | Introduction: The introduction of targeted drugs has had a significant impact on the approach to assessing tumour response. These drugs often induce a rapid cytostatic effect associated with a less pronounced and slower tumoural volume reduction, thereby impairing the correlation between the absence of tumour shrinkage and the patient’s unlikelihood of benefit. The aim of the study was to assess the predictive value of early metabolic response (mR) evaluation after one cycle, and its interlesional heterogeneity to a later metabolic and morphological response assessment performed after three cycles in metastatic colorectal cancer (mCRC) patients treated with combined sorafenib and capecitabine. Methods: This substudy was performed within the framework of a wider prospective multicenter study on the predictive value of early FDG PET-CT response assessment (SoMore study). A lesion-based response analysis was performed, including all measurable lesions identified on the baseline PET. On a per-patient basis, a descriptive 4-class response categorization was applied based upon the presence and proportion of non-responding lesions. For dichotomic response comparison, all patients with at least one resistant lesion were classified as non-responding. Results: On baseline FDG PET-CT, 124 measurable “target” lesions were identified in 38 patients. Early mR assessments showed 18 patients (47 %) without treatment resistant lesions and 12 patients (32 %) with interlesional response heterogeneity. The NPV and PPV of early mR were 85 % (35/41) and 84 % (70/83), respectively, on a per-lesion basis and 95 % (19/20) and 72 % (13/18), respectively, on a dichotomized per-patient basis. Conclusions: Early mR assessment performed after one cycle of sorafenib-capecitabine in mCRC is highly predictive of non-response at a standard response assessment time. The high NPV (95 %) of early mR could be useful as the basis for early treatment discontinuation or adaptation to spare patients from exposure to non-effective drugs. SCOPUS: ar.j info:eu-repo/semantics/published |
| Databáze: | OpenAIRE |
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