Early prediction of response to sunitinib after imatinib failure by 18F-fluorodeoxyglucose positron emission tomography in patients with gastrointestinal stromal tumor.

Détails

ID Serval
serval:BIB_F2D4ECD270E8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Early prediction of response to sunitinib after imatinib failure by 18F-fluorodeoxyglucose positron emission tomography in patients with gastrointestinal stromal tumor.
Périodique
Journal of Clinical Oncology
Auteur(s)
Prior J.O., Montemurro M., Orcurto M.V., Michielin O., Luthi F., Benhattar J., Guillou L., Elsig V., Stupp R., Delaloye A.B., Leyvraz S.
ISSN
1527-7755[electronic]
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
27
Numéro
3
Pages
439-445
Langue
anglais
Résumé
PURPOSE: Positron emission tomography with (18)F-fluorodeoxyglucose (FDG-PET) was used to evaluate treatment response in patients with gastrointestinal stromal tumors (GIST) after administration of sunitinib, a multitargeted tyrosine kinase inhibitor, after imatinib failure. PATIENTS AND METHODS: Tumor metabolism was assessed with FDG-PET before and after the first 4 weeks of sunitinib therapy in 23 patients who received one to 12 cycles of sunitinib therapy (4 weeks of 50 mg/d, 2 weeks off). Treatment response was expressed as the percent change in maximal standardized uptake values (SUV). The primary end point of time to tumor progression was compared with early PET results on the basis of traditional Response Evaluation Criteria in Solid Tumors (RECIST) criteria. RESULTS: Progression-free survival (PFS) was correlated with early FDG-PET metabolic response (P < .0001). Using -25% and +25% thresholds for SUV variations from baseline, early FDG-PET response was stratified in metabolic partial response, metabolically stable disease, or metabolically progressive disease; median PFS rates were 29, 16, and 4 weeks, respectively. Similarly, when a single FDG-PET positive/negative was considered after 4 weeks of sunitinib, the median PFS was 29 weeks for SUVs less than 8 g/mL versus 4 weeks for SUVs of 8 g/mL or greater (P < .0001). None of the patients with metabolically progressive disease subsequently responded according to RECIST criteria. Multivariate analysis showed shorter PFS in patients who had higher residual SUVs (P < .0001), primary resistance to imatinib (P = .024), or nongastric GIST (P = .002), regardless of the mutational status of the KIT and PDGFRA genes. CONCLUSION: Week 4 FDG-PET is useful for early assessment of treatment response and for the prediction of clinical outcome. Thus, it offers opportunities to individualize and optimize patient therapy.
Mots-clé
Adult, Aged, Antineoplastic Agents/therapeutic use, Disease Progression, Drug Resistance, Neoplasm, Female, Fluorodeoxyglucose F18/diagnostic use, Gastrointestinal Stromal Tumors/drug therapy, Gastrointestinal Stromal Tumors/metabolism, Humans, Indoles/therapeutic use, Male, Middle Aged, Mutation, Piperazines/therapeutic use, Positron-Emission Tomography, Protein-Tyrosine Kinases/antagonists & inhibitors, Proto-Oncogene Proteins c-kit/genetics, Pyrimidines/therapeutic use, Pyrroles/therapeutic use, Receptor, Platelet-Derived Growth Factor alpha/genetics, Salvage Therapy
Pubmed
Web of science
Création de la notice
27/01/2009 14:29
Dernière modification de la notice
20/08/2019 16:20
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