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J Nucl Med. 2008; 49 (Supplement 1):139P
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General Clinical Specialties: General Practice-Oncology

Thyroid and Head & Neck Malignancies

Evaluation of response to sorafenib in metastatic thyroid cancer with FDG PET

Rodolfo Perini1, Daniel Pryma1, Keith Flaherty2, Peter O’Dwyer2, Marcia Brose2 and Chaitanya Divgi1

1 Radiology, Division of Nuclear Medicine; 2 Hematology and Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

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Objectives: The ras oncogene, regulating raf/MEK/ERK pathways, is important in origin and progression of cancers. A BRAF mutation is seen in 29-69% of papillary, 10% of anaplastic and 13% of poorly differentiated thyroid cancers. We explored changes in FDG uptake after sorafenib therapy, and its correlation with RECIST criteria.

Methods: From February 2006 to September 2007, a total of 32 patients with iodine refractory metastatic thyroid cancer were enrolled in a Phase I clinical trial of twice daily sorafenib at the Hospital of the University of Pennsylvania. In addition to physical examination and serum tests, these patients were followed up with contrast enhanced CT as part of the research protocol. Five patients had either PET/CT (3) or PET (2) studies done at our institution before and 20-66 days after first sorafenib dose. Images were acquired 1 hour after the intravenous injection of 555MBq of FDG. Maximum SUV of up to five target lesions per patient was recorded on pre and post therapy scans. Metabolic response was determined by the EORTC PET Study Group Response Criteria and compared to RECIST criteria by CT. Twenty-seven of 32 patients had pre-therapy PET at outside institutions and were excluded.

Results: Three patients had partial metabolic response and two had stable metabolic disease on PET; all 5 patients had stable disease on CT.

Conclusions: Sorafenib causes significant decrease in FDG uptake within 20-66 days of treatment initiation in our patient population, without associated CT changes, which may predict treatment response. Patients currently on therapy are being studied; and a prospective study is planned including pre- and post-therapy PET/CT at our institution.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Perini, R.
Right arrow Articles by Divgi, C.
PubMed
Right arrow Articles by Perini, R.
Right arrow Articles by Divgi, C.