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European Journal of Nuclear Medicine and Molecular Imaging

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30.04.2019 | Original Article

3′-Deoxy-3’-¹⁸F-Fluorothymidine and ¹⁸F-Fluorodeoxyglucose positron emission tomography for the early prediction of response to Regorafenib in patients with metastatic colorectal cancer refractory to all standard therapies

verfasst von: Jeong Eun Kim, Sun Young Chae, Jwa Hoon Kim, Hwa Jung Kim, Tae Won Kim, Kyu-pyo Kim, Sun Young Kim, Jae-Lyun Lee, Seung Jun Oh, Jae Seung Kim, Jin-Sook Ryu, Dae Hyuk Moon, Yong Sang Hong

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 8/2019

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Abstract

Purpose

The purpose of this study was to evaluate the value of 3′-deoxy-3′-¹⁸F-fluorothymidine (¹⁸F-FLT) and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) for early prediction of standard anatomic response and survival outcomes in patients with metastatic colorectal cancer (mCRC) receiving Regorafenib.

Methods

Sixty-eight patients with mCRC refractory to standard cytotoxic chemotherapy were enrolled and received Regorafenib (160 mg/day on days 1–21, following a 7-day break). Standard anatomical response was evaluated every 8 weeks. Both scans were performed before and on day 21 of Regorafenib.

Results

Of the 61 patients included in per-protocol analysis, complete response was not observed, but partial response was observed in 8.2% (n = 5), stable disease in 67.2% (n = 41), and progressive disease in 24.6% (n = 15). The objective response rate was 8.2% and disease control rate 75.4%. Five responders (8.2%) and 13 non-responders (21.3%) met the CT and ¹⁸F-FLT PET/CT criteria (maximum standardized uptake value decrease ≥ 10.6% for responders). Forty-three (70.5%) exhibited discordant responses on CT and ¹⁸F-FLT PET/CT (McNemar test, P < 0.001). At a median follow-up of 8.9 months, median progression-free survival (PFS) and median overall survival (OS) were 3.6 months (95% confidence interval [CI], 3.34–3.80 months) and 8.5 months (95% CI, 6.95–10.10 months), respectively. Comparison of PFS and OS according to ¹⁸F-FLT PET/CT response revealed slightly longer PFS (P = 0.015) in responders, but the correlation with OS was not significant. The PET Response Criteria in Solid Tumours (PERCIST) of ¹⁸F-FDG PET/CT revealed differences in PFS and OS between partial metabolic response (PMR) and non-PMR (P = 0.048 and P = 0.014, respectively), and between progressive metabolic disease (PMD) and non-PMD (P = 0.189 and P = 0.007, respectively).

Conclusions

Survival outcome was significantly associated with PERCIST using ¹⁸F-FDG PET/CT but the change of ¹⁸F-FLT uptake was only slightly associated with PFS. ¹⁸F-FDG PET/CT can be used as imaging biomarker to predict clinical outcomes early in patients with mCRC receiving Regorafenib.

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Titel: 3′-Deoxy-3’-18F-Fluorothymidine and 18F-Fluorodeoxyglucose positron emission tomography for the early prediction of response to Regorafenib in patients with metastatic colorectal cancer refractory to all standard therapies
verfasst von: Jeong Eun Kim
Sun Young Chae
Jwa Hoon Kim
Hwa Jung Kim
Tae Won Kim
Kyu-pyo Kim
Sun Young Kim
Jae-Lyun Lee
Seung Jun Oh
Jae Seung Kim
Jin-Sook Ryu
Dae Hyuk Moon
Yong Sang Hong
Publikationsdatum: 30.04.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 8/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04330-7

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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