Research ArticleOncology

The Predictive Value of Early In-Treatment 18F-FDG PET/CT Response to Chemotherapy in Combination with Bevacizumab in Advanced Nonsquamous Non–Small Cell Lung Cancer

Edwin A. Usmanij, Tinatin Natroshvili, Johanna N.H. Timmer-Bonte, Wim J.G. Oyen, Miep A. van der Drift, Johan Bussink and Lioe-Fee de Geus-Oei
Journal of Nuclear Medicine August 2017, 58 (8) 1243-1248; DOI: https://doi.org/10.2967/jnumed.116.185314

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Study design. PD = progressive disease.

  • FIGURE 2.
    FIGURE 2.

    Kaplan–Meier analysis of PFS and OS stratified using RECIST. For stable disease (SD), median PFS was 8.4 and median OS was 14.5 mo. For partial response (PR), median PFS was 7.4 mo and median OS was 17.6 mo. Log-rank test, P = not significant.

  • FIGURE 3.
    FIGURE 3.

    Kaplan–Meier analysis of PFS and OS stratified using PERCIST. For SMD and PMD, median PFS was 1.7 mo and median OS was 4.4 mo. For PMR, median PFS was 9.1 mo and OS was 22.8 mo. Log-rank test, P < 0.001.

  • FIGURE 4.
    FIGURE 4.

    Baseline (A) and in-treatment (B) 18F-FDG PET/CT in a 51-y-old female patient with NSCLC, stage IVB, with Pancoast tumor in left lung with metastasis in right adrenal gland (white and black arrows). In-treatment 18F-FDG PET/CT showed apparent decrease in uptake classified as PMR. Survival was 12.4 mo.

  • FIGURE 5.
    FIGURE 5.

    Baseline (A) and in-treatment (B) 18F-FDG PET/CT in a 67-y-old female patient with NSCLC, stage IVB, with tumor in left lower lobe with metastases in lymph nodes, lung, liver, and bones. In-treatment 18F-FDG PET/CT showed apparent increase in uptake (open arrows) and new 18F-FDG–avid bone lesions (black arrows), classified as PMD. Survival was 1.7 mo.

Tables

  • TABLE 1

    Patient Characteristics

    CharacteristicValue
    Median age (y)54 (range, 42–81)
    Sex
     Male15 (47%)
     Female17 (53%)
    EGFR mutation status
     EGFR mutation2 (6%)
     No EGFR mutation30 (94%)
    TNM stage (seventh edition)
     IIIB1 (4%)
     IV31 (96%)
    Smoking status
     Current smoker15 (47%)
     Former smoker17 (53%)
    Previous malignancy
     No6 (19%)
     Yes26 (81%)
    CPB treatment cycles
     46 (19%)
     426 (81%)
    Bevacizumab maintenance cycles
     06 (19%)
     ≥126 (81%)
    Bevacizumab and erlotinib maintenance cycles
     011 (34%)
     ≥121 (66%)
  • TABLE 2

    Comparison of In-Treatment Response Between PERCIST and RECIST

    RECIST
    PERCISTComplete response (n = 0)Partial response (n = 6)Stable disease (n = 19)Progressive disease (n = 0)
    CMR (n = 0)0000
    PMR (n = 19)05140
    SMD (n = 4)0130
    PMD (n = 2)0020

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