title: FDG-PET predicts survival in recurrent high-grade gliomas treated with bevacizumab and irinotecan.
abstract: Prognosis of recurrent high-grade glioma (HGG) is poor, although bevacizumab has been documented in that context. This study aimed to determine the independent prognostic value of fluorodeoxyglucose (FDG)-PET on progression-free survival (PFS) and overall survival (OS) of recurrent HGG after combined treatment with bevacizumab and irinotecan, compared with other documented prognostic variables. Twenty-five adult patients with histologically proven HGG were included at recurrence. Brain FDG-PET imaging was performed within 6 weeks of starting chemotherapy with bevacizumab and irinotecan. Response based on MRI was assessed every 2 months according to revised assessment in Neuro-Oncology (RANO) criteria. Median PFS and OS were 4 months (range, 0.9-10.4 months) and 7.2 months (range, 1.2-41.7 months), respectively. At 6 months, PFS and OS rate were 16.0% and 72.0%. FDG uptake was the most powerful predictor of both PFS and OS, using either univariate or multivariate analysis, among all variables tested: histological grade, Karnofsky performance status, steroid intake, and number of previous treatments. Moreover, FDG uptake was also prognostic of response to bevacizumab-based therapy. This study provides the first evidence that pretreatment FDG-PET can serve as an imaging biomarker in recurrent HGG for predicting survival following anti-angiogenic therapy with bevacizumab.
authors.affiliation: Service Central de Biophysique et Médecine Nucléaire, Assistance Publique des Hôpitaux de Marseille, CHU Timone,Aix-Marseille University, Marseille, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Colavolpe
authors.forename: Olivier
authors.initials: O
authors.lastname: Chinot
authors.forename: Philippe
authors.initials: P
authors.lastname: Metellus
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.forename: Maryline
authors.initials: M
authors.lastname: Barrie
authors.forename: Céline
authors.initials: C
authors.lastname: Bequet-Boucard
authors.forename: Emeline
authors.initials: E
authors.lastname: Tabouret
authors.forename: Olivier
authors.initials: O
authors.lastname: Mundler
authors.forename: Dominique
authors.initials: D
authors.lastname: Figarella-Branger
authors.forename: Eric
authors.initials: E
authors.lastname: Guedj
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D019788:Fluorodeoxyglucose F18; D005910:Glioma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000068258:Bevacizumab; D000077146:Irinotecan; D002166:Camptothecin