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Research ArticleClinical Investigation

18F-FDG PET/CT Prediction of Treatment Outcomes in Human Papillomavirus–Positive, Locally Advanced Oropharyngeal Cancer Patients Receiving Deintensified Therapy: Results from NRG-HN002

Rathan M. Subramaniam, Lyudmila DeMora, Min Yao, Sue S. Yom, Maura Gillison, Jimmy J. Caudell, John Waldron, Ping Xia, Christine H. Chung, Minh Tam Truong, Michelle Echevarria, Jason W. Chan, Jessica L. Geiger, Loren Mell, Samantha Seaward, Wade L. Thorstad, Jonathan Jay Beitler, Khalil Sultanem, Diagjin Blakaj and Quynh-Thu Le
Journal of Nuclear Medicine March 2023, 64 (3) 362-367; DOI: https://doi.org/10.2967/jnumed.122.264424
Rathan M. Subramaniam
1Otago Medical School, University of Otago, Otago, New Zealand;
2Duke University, Durham, North Carolina;
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Lyudmila DeMora
3NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania;
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Min Yao
4University Hospitals Cleveland, Cleveland, Ohio;
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Sue S. Yom
5University of California, San Francisco, California;
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Maura Gillison
6University of Texas MD Anderson Cancer Center, Houston, Texas;
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Jimmy J. Caudell
7Moffitt Cancer Center, Tampa, Florida;
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John Waldron
8Princess Margaret Hospital, Toronto, Oneida, Canada;
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Ping Xia
9Cleveland Clinic, Cleveland, Ohio;
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Christine H. Chung
7Moffitt Cancer Center, Tampa, Florida;
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Minh Tam Truong
10Boston Medical Center, Boston, Massachusetts;
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Michelle Echevarria
7Moffitt Cancer Center, Tampa, Florida;
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Jason W. Chan
5University of California, San Francisco, California;
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Jessica L. Geiger
11Case Western Reserve University, Cleveland, Ohio;
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Loren Mell
12UC San Diego Moores Cancer Center, San Diego, California;
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Samantha Seaward
13Kaiser Permanente NCI Community Oncology Research Program, Vallejo, California;
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Wade L. Thorstad
14Washington University School of Medicine, St. Louis, Missouri;
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Jonathan Jay Beitler
15Emory University/Winship Cancer Institute, Atlanta, Georgia;
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Khalil Sultanem
16Jewish General Hospital, Montreal, Canada;
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Diagjin Blakaj
17Ohio State University Comprehensive Cancer Center, Columbus, Ohio; and
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Quynh-Thu Le
18Stanford University, Stanford, California
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    TABLE 1.

    NPV per Central Review for 2-Year PFS

    PET/CT result and outcomeIMRT + cisplatinIMRTTotal
    PET overall interpretation
     Positive for residual tumor0 (0.0%)2 (3.4%)2 (1.7%)
     Negative for residual tumor57 (100.0%)56 (96.6%)113 (98.3%)
    2-y PFS status in PET-negative
     Failure4 (7.0%)5 (8.9%)9 (8.0%)
     Nonfailure53 (93.0%)51 (91.1%)104 (92.0%)
    NPV of 2-y PFS93.0%91.1%92.0%
     95% exact CI83.0%–98.1%80.4%–97.0%85.4%–96.3%
     One-sided 90% exact LCB86.5%84.1%87.7%
    H0: NPV ≤ 90% vs. HA: NPV > 90%
     P value (exact)0.2964
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    TABLE 2.

    NPV per Central Review for 2-Year LRC

    PET/CT result and outcomeIMRT + cisplatinIMRTTotal
    PET overall interpretation
     Positive for residual tumor0 (0.0%)2 (3.6%)2 (1.8%)
     Negative for residual tumor56 (100.0%)54 (96.4%)110 (98.2%)
    2-y LRC status in PET-negative
     Failure3 (5.4%)3 (5.6%)6 (5.5%)
     Nonfailure53 (94.6%)51 (94.4%)104 (94.5%)
    NPV of 2-y LRC94.6%94.4%94.5%
     95% exact CI85.1%–98.9%84.6%–98.8%88.5%–98.0%
     One-sided 90% exact LCB88.5%88.0%90.6%
    H0: NPV ≤ 90% vs HA: NPV > 90%
     P value (exact)0.0682

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Journal of Nuclear Medicine: 64 (3)
Journal of Nuclear Medicine
Vol. 64, Issue 3
March 1, 2023
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18F-FDG PET/CT Prediction of Treatment Outcomes in Human Papillomavirus–Positive, Locally Advanced Oropharyngeal Cancer Patients Receiving Deintensified Therapy: Results from NRG-HN002
Rathan M. Subramaniam, Lyudmila DeMora, Min Yao, Sue S. Yom, Maura Gillison, Jimmy J. Caudell, John Waldron, Ping Xia, Christine H. Chung, Minh Tam Truong, Michelle Echevarria, Jason W. Chan, Jessica L. Geiger, Loren Mell, Samantha Seaward, Wade L. Thorstad, Jonathan Jay Beitler, Khalil Sultanem, Diagjin Blakaj, Quynh-Thu Le
Journal of Nuclear Medicine Mar 2023, 64 (3) 362-367; DOI: 10.2967/jnumed.122.264424

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18F-FDG PET/CT Prediction of Treatment Outcomes in Human Papillomavirus–Positive, Locally Advanced Oropharyngeal Cancer Patients Receiving Deintensified Therapy: Results from NRG-HN002
Rathan M. Subramaniam, Lyudmila DeMora, Min Yao, Sue S. Yom, Maura Gillison, Jimmy J. Caudell, John Waldron, Ping Xia, Christine H. Chung, Minh Tam Truong, Michelle Echevarria, Jason W. Chan, Jessica L. Geiger, Loren Mell, Samantha Seaward, Wade L. Thorstad, Jonathan Jay Beitler, Khalil Sultanem, Diagjin Blakaj, Quynh-Thu Le
Journal of Nuclear Medicine Mar 2023, 64 (3) 362-367; DOI: 10.2967/jnumed.122.264424
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Keywords

  • PET/CT negative predictive value
  • p16-positive oropharyngeal cancer
  • NRG-HN002
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