Yifei Ma1,2, Wei Xu1, Ruojing Bai3, Yiming Li4, Hongyu Yu5, Chunshan Yang6,7, Huazheng Shi7, Jian Zhang7, Jidong Li8, Chenguang Wang9, Jianru Xiao10. 1. Department of Orthorpedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. 2. Department of Pathology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. 3. Department of Geriatrics, Tianjin Medical University General Hospital, Laboratory of Neuro-Trauma and Neurodegenerative Disorder, Geriatrics Institute, Tianjin, 300352, China. 4. Department of Neuro-oncology, Neurosurgery Institute, Beijing, 100000, China. 5. Department of Pathology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. yuhongyucz@aliyun.com. 6. Department of PET/CT Radiology, Panorama Medical Imaging Center, Shanghai, China. 7. Department of PET/CT Radiology Center, Number 85 Hospital of PLA, 1328 Huashan Road, Shanghai, 200004, China. 8. Department of Stomatology, The First People's Hospital of Shangqiu, Shangqiu, 476100, Henan Province, China. 9. Department of Radiology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. 10. Department of Orthorpedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China. jianruxiao83@163.com.
Abstract
PURPOSE: To test the performance of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). METHODS: CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. RESULTS: Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. CONCLUSION: Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome.
PURPOSE: To test the performance of sequential 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). METHODS: CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. RESULTS: Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. CONCLUSION:Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome.
Entities:
Keywords:
Cancer of unknown primary; Sunitinib; Survival prediction; Volume-based PET/CT parameters
Authors: Robert J Motzer; Brian I Rini; Ronald M Bukowski; Brendan D Curti; Daniel J George; Gary R Hudes; Bruce G Redman; Kim A Margolin; Jaime R Merchan; George Wilding; Michelle S Ginsberg; Jennifer Bacik; Sindy T Kim; Charles M Baum; M Dror Michaelson Journal: JAMA Date: 2006-06-07 Impact factor: 56.272
Authors: Hubert Vesselle; Joseph D Freeman; Linda Wiens; Joshua Stern; Huang Q Nguyen; Stephen E Hawes; Philip Bastian; Alexander Salskov; Eric Vallières; Douglas E Wood Journal: Clin Cancer Res Date: 2007-06-01 Impact factor: 12.531