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J Nucl Med. 2008; 49 (Supplement 1):364P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Early PET monitoring of combined rexinoid and EGFR tyrosine kinase inhibitor therapy in advanced non-small cell lung cancer (NSCLC)

Marc Seltzer1, Konstantin Dragnev1, James Rigas1, Wendye DiSalvo1, Sara Simeone1 and Ethan Dmitrovsky1

1 Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire

1540

Objectives: To determine the role of FDG-PET in monitoring early response to combined rexinoid and EGFR tyrosine kinase inhibitor therapy in patients with advanced NSCLC.

Methods: Twelve patients (pts) with stage IV NSCLC (median age 64) were treated with bexarotene 400 mg/m2 and erlotinib 150 mg daily orally. Most had failed more than 2 prior chemo regimens. FDG PET-CT scans were acquired at baseline and at 8-12 days of therapy. Conventional radiographic response was evaluated at 2 months of therapy with CT using RECIST criteria. PET response was based on the pre and 8-12 day PET scan using the European Organization for Research and Treatment of Cancer criteria for PET metabolic response. Early response by PET at 8-12 days was correlated with radiographic response at 2 months.

Results: Based on radiographic response at 2 months, there was one complete responder (early PET showing metabolic response), 1 partial responder (early PET showing metabolic progression), 2 stable disease (early PET stable in 1 and progression in 1), and 8 with progression of disease (early PET stable in 5 and progression in 3).

Conclusions: In this select group of pts with advanced and heavily pre-treated NSCLC, absence of a change or an increase in activity on early PET at 8-12 days of therapy was not predictive of radiographic response at 2 months in the majority of patients. Early decrease in activity may predict a radiographic response. The observed early PET metabolic progression in a partial responder suggests a "flare" phenomenon. A larger sample size including a higher number of responding patients (lower stage, less heavily pretreated) is required to further define the role of early PET for assessing response to anti-EGFR based therapy.

Research Support: Genentech, Ligand, and Eisai





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Seltzer, M.
Right arrow Articles by Dmitrovsky, E.
PubMed
Right arrow Articles by Seltzer, M.
Right arrow Articles by Dmitrovsky, E.