Monitoring of tumour glucose metabolism by PET in a phase I study evaluating hormonal therapy in advanced pancreatic cancer.
BACKGROUND
Positron emission tomography (PET) determines therapy-induced changes in tumour glucose utilization. Experimental data indicate that cholecystokinin (CCK) stimulates pancreatic cancer growth. In this study in patients with advanced pancreatic cancer, we evaluated the use of fluorodeoxyglucose (FDG) PET compared with magnetic resonance imaging (MRI) in monitoring hormonal therapy using a highly selective, non-peptide CCK receptor antagonist (SR 27897B).


METHODS
Nineteen patients were enrolled on a 28-day course of SR 27897B. Initially, 4 patients received 20 mg of SR 27897B; 9 patients received 40 mg; and 6 patients 80 mg. Imaging studies, including FDG-PET and MRI, were performed at baseline and on days 14 and 28.


RESULTS
No significant changes in FDG uptake by the primary tumours were observed. Rate of progression of disease was 11 (61%) of 18 evaluable patients by MRI. Median survival of all patients enrolled was 2.7 months. SR 27897B was fairly well tolerated at all doses tested. The most common side effects were gastrointestinal disorders such as diarrhoea, flatulence and nausea.


CONCLUSIONS
SR 27897B, when used alone at the limited doses employed, led neither to an impairment of tumour glucose metabolism nor to a reduction of tumour size in advanced pancreatic cancer.
Eckel
F
F
Dept of Medicine II, Klinikum rechts der Isar, Technical University of Munich, Germany. florian.eckel@lrz.tum.de
Lersch
C
C
Lippl
F
F
Schulte-Frohlinde
E
E
Schusdziarra
V
V
Helmberger
H
H
Neverve
J
J
Decker
M
M
Frank
R
R
Schwaiger
M
M
Weber
W
W
D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007210:Indoleacetic Acids / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D019275:Radiopharmaceuticals; D011949:Receptors, Cholecystokinin / Q000037:antagonists & inhibitors*; D013844:Thiazoles / Q000627:therapeutic use*; D014055:Tomography, Emission-Computed
D006727:Hormone Antagonists; D007210:Indoleacetic Acids; D019275:Radiopharmaceuticals; D011949:Receptors, Cholecystokinin; D013844:Thiazoles; D019788:Fluorodeoxyglucose F18; C080460:SR 27897; D005947:Glucose