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SHR Neuro Cancer Cardio Lipid Metab Microb

Schwarzenberg, J; Czernin, J; Cloughesy, TF; Ellingson, BM; Pope, WB; Grogan, T; Elashoff, D; Geist, C; Silverman, DH; Phelps, ME; Chen, W.
Treatment response evaluation using 18F-FDOPA PET in patients with recurrent malignant glioma on bevacizumab therapy.
Clin Cancer Res. 2014; 20(13):3550-3559 Doi: 10.1158/1078-0432.CCR-13-1440 [OPEN ACCESS]
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Leading authors Med Uni Graz: Schwarzenberg Johannes
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Abstract:: This study compares the value of 3,4-dihydroxy-6-[(18)F]-fluoro-l-phenylalanine ((18)F-FDOPA) positron emission tomography (PET) and MRI in assessing outcome during antiangiogenic treatment in patients with recurrent high-grade gliomas. Thirty patients were prospectively studied with (18)F-FDOPA PET scans immediately before, and two and six weeks after start of bevacizumab therapy. (18)F-FDOPA metabolic tumor volumes (MTV) as well as max and mean standardized uptake values (SUV) within this MTV were obtained. MRI treatment response was assessed at six weeks. The predictive ability of (18)F-FDOPA PET and MRI response assessment were evaluated with regard to progression-free survival (PFS) and overall survival (OS). A total of 30, 28, and 24 (18)F-FDOPA PET scans at baseline, two weeks, and six weeks, were available for analysis, respectively. (18)F-FDOPA PET SUVs as well as their changes through therapy were not predictive of outcome. However, MTV parameters such as MTV changes were highly prognostic. Interestingly, absolute MTV at the first follow up scan provides the most significant prediction for increased OS (P < 0.0001) as well as PFS (P = 0.001). This surprising result was scrutinized with cross-validation and simulation analysis. Responders based on (18)F-FDOPA PET data survived 3.5 times longer (12.1 months vs. 3.5 months, median OS, P < 0.001) than nonresponders (17 patients vs. 11 patients, respectively). In comparison, responders based on MRI data lived 1.5 times longer (11.4 months vs 7.7 months, P = 0.03) than nonresponders (22 patients vs. 7 patients, respectively). (18)F-FDOPA PET identifies treatment responders to antiangiogenic therapy as early as two weeks after treatment initiation. ©2014 American Association for Cancer Research.
Find related publications in this database (using NLM MeSH Indexing): Adult -; Aged -; Angiogenesis Inhibitors - administration & dosage Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - administration & dosage Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Agents - administration & dosage Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab -; Brain Neoplasms - diagnosis Brain Neoplasms - drug therapy Brain Neoplasms - mortality; Dihydroxyphenylalanine - analogs & derivatives Dihydroxyphenylalanine - metabolism; Female -; Glioma - diagnosis Glioma - drug therapy Glioma - mortality; Humans -; Male -; Middle Aged -; Neoplasm Grading -; Neoplasm Recurrence, Local -; Positron-Emission Tomography -; Prognosis -; Treatment Outcome -; Tumor Burden -