FDG-PET predicts chemotherapy response in lung cancer cases

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Positron emission tomography (PET) imaging can provide an early indication of chemotherapy response in non–small cell lung cancer patients to aid doctors in guiding treatment, according to research published in the May Journal of Nuclear Medicine published by SNM (Society of Nuclear Medicine).
“Our study demonstrates that patients who respond to chemotherapy can be identified early in the course of their treatment, and these patients will generally exhibit prolonged overall survival,” said Claude Nahmias, PhD, professor of radiology and medicine at the University of Tennessee Medical Center in Knoxville, a study co-author. “Although we studied a relatively small number of patients—and our results should be interpreted with caution—it is clear that a repeat PET study with the radiotracer fluorodeoxyglucose (FDG) at the end of the first cycle of chemotherapy would allow the identification of those patients for whom the therapy was futile.”

“The ability to provide an early indication of therapeutic response has the potential to improve patient care by identifying those patients who do not benefit from their current treatment,” added Nahmias. “Patients would benefit from either having chemotherapy and its associated toxic side effects stopped or going on to a different, and hopefully more adequate, therapeutic approach.”

Non–small cell lung cancer is the most common type of lung cancer, usually growing and spreading more slowly than small cell lung cancer. And for most patients with non–small cell lung cancer, current treatments do not cure the cancer.

“With non–small cell lung cancer—since the relatively modest increase in survival must be balanced against the toxicity of the chemotherapeutic treatment—the case for monitoring therapeutic response is especially compelling,” said Nahmias.

“To assess the response to chemotherapy in patients with advanced non–small cell lung cancer, all of the studies published thus far have evaluated the patients at one, or at most two, time points after the initiation of chemotherapy,” said Nahmias. “In our study, we evaluated 15 patients weekly—for seven weeks—as they started their chemotherapy regimen. In spite of the persuasive findings of several studies investigating PET for monitoring response to cancer therapy, until now no published reports have clearly demonstrated that PET results were used to alter treatment,” he added.

The data is published in the study “Time Course of Early Response to Chemotherapy in Non–Small Cell Lung Cancer Patients With 18F-FDG PET/CT.”