Tatsuya Yoshida1, Hirotaka Tanaka2, Hiroaki Kuroda3, Junichi Shimizu4, Yoshitsugu Horio4, Yukinori Sakao3, Yoshitaka Inaba5, Hiroshi Iwata2, Toyoaki Hida4, Yasushi Yatabe6. 1. Department of Thoracic Oncology, Aichi Cancer Center Hospital, Japan. Electronic address: t.yoshida@aichi-cc.jp. 2. East Nagoya Imaging Diagnosis Center, Japan. 3. Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan. 4. Department of Thoracic Oncology, Aichi Cancer Center Hospital, Japan. 5. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Japan. 6. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan.
Abstract
BACKGROUND: The development of epidermal growth factor receptor (EGFR) T790M point mutation in exon 20 (T790M) is the most common mechanism of resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The purpose of this study was to determine the association of (18)F-2-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) metrics with T790M status after acquiring resitance to EGFR-TKI resistance. METHODS: We retrospectively reviewed 34 advanced non-small cell lung cancer (NSCLC) patients harboring EGFR mutation who underwent rebiopsy and FDG-PET/CT before rebiopsy. These patients were evaluated for baseline characteristics, initial response to EGFR-TKIs, site of rebiopsy, overall survival, and FDG-PET/CT metrics, such as standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis of the rebiopsy site. RESULTS: The median age was 67 years (range, 37-86 years); 19 of the patients (56%) were men. Histologic examination revealed adenocarcinoma in all but one patient, with 20 patients (59%) having stage IIIB and IV disease. Upon initial mutational analyses, the types of EGFR mutation included 17 (50%) deletions in exon 19 and 17 (50%) L858R point mutations in exon 21. At the time of acquired resistance to EGFR-TKIs, T790M mutation was identified in 20 (59%) patients. T790M-positive patients had significantly lower levels of median SUVmean and median SUVmax of the rebiopsy site on FDG-PET/CT, compared with T790M-negative patients (SUVmean: 4.57 vs. 9.91, P=0.0069; SUVmax: 7.26 vs. 16.06, P=0.0054). The survival in patients who acquired T790M after failure of EGFR-TKIs was significantly longer than those without T790M (10.2 mos. vs. 18.6 mos., P<0.05). CONCLUSION: T790M status was associated with lower levels of SUVmean and SUVmax on FDG-PET/CT and significantly longer survival.
BACKGROUND: The development of epidermal growth factor receptor (EGFR) T790M point mutation in exon 20 (T790M) is the most common mechanism of resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The purpose of this study was to determine the association of (18)F-2-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) metrics with T790M status after acquiring resitance to EGFR-TKI resistance. METHODS: We retrospectively reviewed 34 advanced non-small cell lung cancer (NSCLC) patients harboring EGFR mutation who underwent rebiopsy and FDG-PET/CT before rebiopsy. These patients were evaluated for baseline characteristics, initial response to EGFR-TKIs, site of rebiopsy, overall survival, and FDG-PET/CT metrics, such as standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis of the rebiopsy site. RESULTS: The median age was 67 years (range, 37-86 years); 19 of the patients (56%) were men. Histologic examination revealed adenocarcinoma in all but one patient, with 20 patients (59%) having stage IIIB and IV disease. Upon initial mutational analyses, the types of EGFR mutation included 17 (50%) deletions in exon 19 and 17 (50%) L858R point mutations in exon 21. At the time of acquired resistance to EGFR-TKIs, T790M mutation was identified in 20 (59%) patients. T790M-positive patients had significantly lower levels of median SUVmean and median SUVmax of the rebiopsy site on FDG-PET/CT, compared with T790M-negative patients (SUVmean: 4.57 vs. 9.91, P=0.0069; SUVmax: 7.26 vs. 16.06, P=0.0054). The survival in patients who acquired T790M after failure of EGFR-TKIs was significantly longer than those without T790M (10.2 mos. vs. 18.6 mos., P<0.05). CONCLUSION:T790M status was associated with lower levels of SUVmean and SUVmax on FDG-PET/CT and significantly longer survival.
Authors: Hyungjin Kim; Kum Ju Chae; Soon Ho Yoon; Miso Kim; Bhumsuk Keam; Tae Min Kim; Dong-Wan Kim; Jin Mo Goo; Chang Min Park Journal: Eur Radiol Date: 2017-08-07 Impact factor: 5.315
Authors: Paul Zarogoulidis; Mina Gaga; Haidong Huang; Kaid Darwiche; Aggeliki Rapti; Wolfgang Hohenforst-Schmidt Journal: Clin Transl Med Date: 2017-01-18