title: Response to Early Treatment Evaluated with 18F-FDG PET and PERCIST 1.0 Predicts Survival in Patients with Ewing Sarcoma Family of Tumors Treated with a Monoclonal Antibody to the Insulinlike Growth Factor 1 Receptor.
abstract: The aim of this study was to assess the prognostic and predictive value of early quantitative (18)F-FDG PET to monitor therapy with an antibody to the insulinlike growth factor 1 receptor (IGF-1R antibody) in patients with Ewing sarcoma family of tumors (ESFT).
  
  
  METHODS
  (18)F-FDG PET images at baseline and approximately 9 d after initiation of IGF-1R antibody therapy in 115 patients with refractory or relapsed ESFT were prospectively obtained as part of the Sarcoma Alliance for Research through Collaboration trial. Responses were centrally evaluated by PERCIST 1.0 in 93 patients. The 9-d PET responses were correlated to overall survival (OS), progression-free survival (PFS), and clinical benefit after 6 wk of therapy based on clinical observation and CT response by World Health Organization anatomic criteria.
  
  
  RESULTS
  The median OS was 8.1 mo (95% confidence interval, 6.4-10.0 mo). When PERCIST was used, patients with progressive metabolic disease showed shorter OS (median, 4.7 mo) than patients without progression (median, 10.0 mo; P = 0.001). Progressive metabolic disease on day-9 PET was associated with a significantly higher risk of death (hazard ratio, 2.8; 95% confidence interval, 1.5-5.5). Changes in (18)F-FDG uptake after 9 d of therapy had an area under the curve of receiver-operating characteristic of 0.71 to predict 1-y OS. The area under the curve was 0.63 to predict progression at 3 mo and 0.79 to predict clinical benefit after 6 wk of therapy.
  
  
  CONCLUSIONS
  Treatment response by quantitative (18)F-FDG PET assessed by PERCIST 1.0 as early as 9 d into IGF-1R antibody therapy in patients with ESFT can predict the OS, PFS, and clinical response to therapy.
authors.affiliation: Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Joo
authors.initials: J
authors.lastname: Hyun O
authors.affiliation: Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Luber
authors.affiliation: Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Leal
authors.affiliation: Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Cancer Research and Biostatistics, Seattle, Washington.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bolejack
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Schuetze
authors.affiliation: Department of Radiology, Columbia University, New York, New York.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.affiliation: Pediatric Oncology Branch, National Cancer Institute, Bethesda, Maryland; and.
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Helman
authors.affiliation: SARC, Ann Arbor, Michigan.
authors.forename: Denise
authors.initials: D
authors.lastname: Reinke
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
authors.forename: Laurence H
authors.initials: LH
authors.lastname: Baker
authors.affiliation: Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland wahlr@mir.wustl.edu.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D017526:Receptor, IGF Type 1 / Q000276:immunology*; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D019788:Fluorodeoxyglucose F18; D017526:Receptor, IGF Type 1; D005947:Glucose
keywords: 18F-FDG PET; insulin-like growth factor; sarcoma