Adaptive Fluorodeoxyglucose-Positron Emission Tomography Based Chemotherapy Selection for Metastatic Non-small Cell Lung Cancer.
(18f)-fdg pet
adaptive clinical trial
cisplatin
metastatic
non-small cell lung cancer
paclitaxel
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
accepted:
15
10
2021
entrez:
19
11
2021
pubmed:
20
11
2021
medline:
20
11
2021
Statut:
epublish
Résumé
Objectives The change in tumor fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET) scan after one cycle of platinum-based chemotherapy has been shown to predict progression-free and overall survival (PFS and OS) among advanced non-small cell lung cancer (NSCLC) patients. Using early FDG-PET response to determine subsequent chemotherapy, we aim to evaluate the role that adaptive chemotherapy regimens have on later CT response, PFS, and OS in patients with advanced NSCLC. Materials and Methods Chemotherapy-naïve patients with metastatic NSCLC received carboplatin and paclitaxel (CP) on day one and repeated FDG-PET on day 18. PET-responding patients continued CP chemotherapy for a total of four cycles. PET non-responders were switched to alternate docetaxel and gemcitabine (DG) for three additional cycles. The primary outcome was the CT Response Evaluation Criteria in Solid Tumors (RECIST 1.0) response. Secondary endpoints included PFS and OS. Results Forty-six patients initiated treatment with chemotherapy on trial and were evaluable by PET/CT. Of these, 19 (41%) met the FDG-PET criteria for the response after a single cycle of CP. Only one non-responding patient had a CT response. Despite the lack of CT response in the DG arm, no trend for worse PFS or OS was seen between the two arms. Conclusions This work demonstrates that changing chemotherapy in the event of non-response by PET did not lead to improved CT RECIST response. However, non-responding patients who switched chemotherapy had similar PFS and OS to those who responded by PET and continued the same regimen.
Identifiants
pubmed: 34796077
doi: 10.7759/cureus.18804
pmc: PMC8590825
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e18804Subventions
Organisme : NCI NIH HHS
ID : T32 CA009515
Pays : United States
Informations de copyright
Copyright © 2021, Eaton et al.
Déclaration de conflit d'intérêts
Hubert Vesselle - received consultant fees on image display software for MIM Software Inc.
Références
J Thorac Oncol. 2009 Jul;4(7):816-21
pubmed: 19487962
Int J Comput Assist Radiol Surg. 2013 Mar;8(2):181-91
pubmed: 22644386
Eur J Nucl Med Mol Imaging. 2015 Feb;42(2):241-51
pubmed: 25193652
Cancer Imaging. 2012 Sep 28;12:324-35
pubmed: 23023063
World J Radiol. 2014 Jul 28;6(7):392-8
pubmed: 25071879
EJNMMI Res. 2019 Jan 29;9(1):8
pubmed: 30694399
Ann Oncol. 2005 Apr;16(4):602-10
pubmed: 15741225
J Thorac Oncol. 2016 Apr;11(4):537-44
pubmed: 26724474
J Natl Cancer Inst. 2000 Feb 2;92(3):205-16
pubmed: 10655437
J Nucl Med. 2003 Feb;44(2):224-39
pubmed: 12571214
J Clin Oncol. 2005 May 1;23(13):2937-45
pubmed: 15728228
J Nucl Med. 2007 Oct;48(10):1592-8
pubmed: 17873138
J Clin Oncol. 2008 Jan 20;26(3):463-7
pubmed: 18202421
Ann Nucl Med. 2020 Dec;34(12):968-974
pubmed: 33070295
J Nucl Med. 1999 Nov;40(11):1771-7
pubmed: 10565769
Eur J Nucl Med Mol Imaging. 2020 May;47(5):1158-1167
pubmed: 31760467
PLoS One. 2018 May 23;13(5):e0197754
pubmed: 29791503
J Nucl Med. 2007 May;48(5):744-51
pubmed: 17475962
J Clin Oncol. 2005 Nov 20;23(33):8362-70
pubmed: 16293866
J Nucl Med. 2002 Oct;43(10):1304-9
pubmed: 12368367
Nucl Med Biol. 2000 Oct;27(7):683-7
pubmed: 11091112
J Nucl Med. 2002 Aug;43(8):1018-27
pubmed: 12163626
J Nucl Med. 2009 May;50 Suppl 1:122S-50S
pubmed: 19403881
J Clin Oncol. 2003 Jul 15;21(14):2651-7
pubmed: 12860940
Anticancer Res. 2005 Nov-Dec;25(6C):4591-4
pubmed: 16334147
J Nucl Med. 2005 Jun;46(6):983-95
pubmed: 15937310
J Nucl Med. 2005 Jul;46(7):1144-50
pubmed: 16000283
J Nucl Med. 2020 Jul;61(7):990-998
pubmed: 31806768
J Clin Oncol. 2005 Oct 20;23(30):7445-53
pubmed: 16157939
Lung Cancer. 2006 Oct;54(1):41-9
pubmed: 16919841
Eur J Nucl Med Mol Imaging. 2012 Jan;39(1):27-38
pubmed: 21946983
Cancer. 2001 Dec 1;92(11):2902-10
pubmed: 11753965
J Nucl Med. 2007 Jan;48 Suppl 1:36S-44S
pubmed: 17204719
Cancer. 2006 Feb 1;106(3):494-504
pubmed: 16353212
J Nucl Med. 2006 Aug;47(8):1241-8
pubmed: 16883000
Eur J Nucl Med Mol Imaging. 2018 Jan;45(1):56-66
pubmed: 28828507
Eur J Cancer. 2006 May;42(8):1031-9
pubmed: 16616487
J Clin Oncol. 2001 Jun 15;19(12):3058-65
pubmed: 11408502
AJR Am J Roentgenol. 2018 Nov;211(5):1010-1019
pubmed: 30063366