FDG-PET/CT for the evaluation of response to therapy of cutaneous T-cell lymphoma to vorinostat (suberoylanilide hydroxamic acid, SAHA) in a phase II trial.
BACKGROUND
Harnessing the power of molecular imaging in particular positron emission tomography (PET) to assess response to therapy in early clinical trials has the potential to yield crucial data on efficacy and streamline drug development. Vorinostat (also known as SAHA, suberoylanilide hydroxamic acid) is a histone deacetylase (HDAC) inhibitor which alters gene transcription to inhibit proliferation and promote apoptosis.


METHODS
In a phase II trial of vorinostat for cutaneous T cell lymphoma (CTCL), 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-PET/computed tomography (CT) was performed on patients with both cutaneous and nodal disease. FDG-PET/CT fuses the power of metabolic imaging from FDG-PET with the anatomic detail of CT. Scans were conducted on subjects pre-therapy and during therapy.


RESULTS
Changes in the values of FDG uptake and measurements of nodal dimensions and thickness of cutaneous lesions were tabulated. FDG-PET/CT provided an objective measure of the response (or lack thereof) of both cutaneous and nodal disease to therapy with vorinostat. The results of this study are encouraging for the potential utility of FDG-PET/CT in future trials with HDAC inhibitors for other diseases and for CTCL with other therapies.


CONCLUSIONS
Further study will be required to determine the prognostic value of the initial PET/CT scan and response on follow-up scans.
Kuo
Phillip H
PH
Department of Diagnostic Radiology, Yale University School of Medicine and Yale New Haven Hospital, New Haven, CT 06520-8059, USA. phillip.kuo@yale.edu
Carlson
Kacie R
KR
Christensen
Inger
I
Girardi
Michael
M
Heald
Peter W
PW
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D056572:Histone Deacetylase Inhibitors; D006801:Humans; D006877:Hydroxamic Acids / Q000627:therapeutic use*; D016410:Lymphoma, T-Cell, Cutaneous / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*; D000077337:Vorinostat
D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D005462:Fluorine Radioisotopes; D056572:Histone Deacetylase Inhibitors; D006877:Hydroxamic Acids; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000077337:Vorinostat