title: (99m)Tc-3PRGD2 SPECT/CT Imaging for Monitoring Early Response of EGFR-TKIs Therapy in Patients with Advanced-Stage Lung Adenocarcinoma.
abstract: OBJECTIVE
  This study was aimed to assess the efficacy of (99m)Tc-3PRGD2 imaging for evaluating both early treatment response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and prognosis in advanced-stage lung adenocarcinoma.
  
  
  METHODS
  Eighteen patients with lung adenocarcinoma were enrolled for EGFR-TKIs therapy. (99m)Tc-3PRGD2 SPECT/CT and planar imaging were performed pre- and post-therapy. The tumor to nontumor (T/NT) ratio and percentage change in T/NT ratio were assessed for the treatment response. Receiver operator characteristic (ROC) analysis was utilized to analyze the power of identifying responders based on the changes in T/NT ratios.
  
  
  RESULTS
  After treatment, 10 patients had partial response (PR), and 6 patients stable disease (SD), while 2 patients progressive disease (PD). The mean changes in T/NT ratios on SPECT/CT and planar images in PR group were 35.8% and 15.0% and in SD group were 8.9% and 0.7%, while in PD group were 76.1% and 18.7%, respectively. For ROC analysis, using a cutoff value of 23.8% decrease in T/NT ratio on SPECT/CT images, the sensitivity and specificity in identifying responders were 80.0% and 87.5%, respectively. The median progression-free survival (PFS) for patients with responders and nonresponders (on (99m)Tc-3PRGD2 SPECT/CT) was 18 months (95% CI 5.8-30.2 months) and 7 months (95% CI 5.2-8.8 months), respectively (p = 0.006).
  
  
  CONCLUSIONS
  (99m)Tc-3PRGD2 imaging can evaluate the early response to EGFR-targeted therapy and predict the PFS of lung adenocarcinoma patients.
authors: 1 Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China .
authors: Zhaoqi
authors: Z
authors: Zhang
authors: 1 Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China .
authors: Xinming
authors: X
authors: Zhao
authors: 2 Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China .
authors: Cuimin
authors: C
authors: Ding
authors: 1 Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China .
authors: Jianfang
authors: J
authors: Wang
authors: 1 Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University , Shijiazhuang, China .
authors: Jingmian
authors: J
authors: Zhang
authors: 3 Medical Isotopes Research Center, Peking University , Beijing, China .
authors: Fan
authors: F
authors: Wang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000368:Aged; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D000072098:Single Photon Emission Computed Tomography Computed Tomography / Q000379:methods
chemical_list: D015609:Organotechnetium Compounds; D010456:Peptides, Cyclic; D047428:Protein Kinase Inhibitors; D019275:Radiopharmaceuticals; C561921:technetium 99m (HYNIC-3PRGD(2))(tricine)(TPPTS); C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: 99mTc-3PRGD2; EGFR-TKIs; SPECT; lung adenocarcinoma; therapy