title: [¹⁸F]FDG positron emission tomography within two weeks of starting erlotinib therapy can predict response in non-small cell lung cancer patients.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate whether [¹⁸F]FDG-PET/CT, performed within two weeks of starting erlotinib therapy can predict tumor response defined by RECIST 1.1 criteria after 8 weeks of treatment in patients with inoperable (stage IIIA to IV) non-small cell lung cancer patients.
  
  
  METHODS
  Three [¹⁸F]FDG-PET/CT scans were acquired in 12 patients before (5±4 days) and after 9±3 days (early PET) and 60±6 days (late PET) of erlotinib therapy. Conventional evaluation, including at least chest CT (baseline versus after 8 weeks of treatment), was performed according to RECIST 1.1 criteria. Change in [¹⁸F]FDG uptake was compared with conventional response, progression-free survival (PFS), and overall survival (OS).
  
  
  RESULTS
  By using ROC analysis, the Area Under the Curve for prediction of metabolic non-progressive disease (mNP) by early PET was 0.86 (95% CI, 0.62 to 1.1; P = 0.04) at a cut-off of 21.6% reduction in maximum Standardized Uptake Value (SUVmax). This correctly classified 11/12 patients (7 with true progressive disease; 4 with true non-progressive disease; 1 with false progressive disease). Non-progressive disease after 8 weeks of treatment according to RECIST 1.1 criteria was significantly more frequent in patients classified mNP (P = 0.01, Fisher's exact test). mNP patients showed prolonged PFS (HR = 0.27; 95% CI, 0.04 to 0.59; P<0.01) and OS (HR = 0.34; 95% CI, 0.06 to 0.84; P = 0.03). Late PET analysis provided concordant results.
  
  
  CONCLUSIONS
  Morphologic response, PFS and OS survival in non-small cell lung cancer patients can be predicted by [¹⁸F]FDG-PET/CT scan within 2 weeks after starting erlotinib therapy.
authors: LUNAM Université, 49 000, Angers, France ; Université d'Angers, CHU Angers, Pôle de Radiologie, Service de Médecine Nucléaire, Angers, France.
authors: Mammar
authors: M
authors: Hachemi
authors: LUNAM Université, 49 000, Angers, France ; Université d'Angers, CHU Angers, Pôle de Radiologie, Service de Médecine Nucléaire, Angers, France ; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, Angers, France.
authors: Olivier
authors: O
authors: Couturier
authors: LUNAM Université, 49 000, Angers, France ; Université d'Angers, CHU Angers, Pôle de Radiologie, Service de Médecine Nucléaire, Angers, France.
authors: Laurent
authors: L
authors: Vervueren
authors: LUNAM Université, 49 000, Angers, France ; Université d'Angers, CHU Angers, Pôle de Radiologie, Service de Médecine Nucléaire, Angers, France.
authors: Pacôme
authors: P
authors: Fosse
authors: LUNAM Université, 49 000, Angers, France ; Université d'Angers, CHU Angers, Pôle de Radiologie, Service de Médecine Nucléaire, Angers, France ; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, Angers, France.
authors: Franck
authors: F
authors: Lacœuille
authors: LUNAM Université, 49 000, Angers, France ; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, Angers, France ; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Département de Pneumologie, Angers, France ; Université d'Angers, Equipe Pyver, Angers, France.
authors: Thierry
authors: T
authors: Urban
authors: LUNAM Université, 49 000, Angers, France ; INSERM UMR_S 1066 Micro et Nanomédecines Biomimétiques, Angers, France ; Université d'Angers, CHU Angers, Pôle des Spécialités Médicales et Chirurgicales Intégrées, Département de Pneumologie, Angers, France ; Université d'Angers, Equipe Pyver, Angers, France.
authors: José
authors: J
authors: Hureaux
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D018572:Disease-Free Survival; D000069347:Erlotinib Hydrochloride; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*; D011799:Quinazolines / Q000008:administration & dosage*; D011859:Radiography; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000069347:Erlotinib Hydrochloride