In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. 7603-7603
Abstract:
7603 Background: Since the introduction of targeted therapy into the treatment of NSCLC, molecular imaging tools gain in importance for assessment of pharmacodynamics, pharmacokinetics and prediction of therapeutic outcome. Tumor metabolism (by FDG-PET), proliferation (by FLT-PET), and vascularization (by DCE-MRI) can be noninvasively assessed to quantify the effects of targeted therapy on tumor biology. We set up a trial to evaluate the effects of combined erlotinib (E) and bevacizumab (B) treatment in patients with advanced non-squamous cell NSCLC and to identify prospectively patients who benefit from this combination. Methods: Patients with non-squamous NSCLC stage IV without prior systemic therapy received at least six weeks of combined E and B. FLT and FDG-PET scans as well as DCE-MRI-scans were performed at baseline, after 1 week of therapy and after 6 weeks of therapy. Standard uptake values of the PET scans and vascularization parameters of the DCE-MRI scans were analyzed and coregistrated. Tumor specimens were analysed within a network screening panel. The primary objective of this trial was to evaluate the accuracy of the imaging tools for early prediction of nonprogression and PFS and its association with molecular markers. Results: Of the 40 patients, all received FDG-PET analyses, whereas FLT-PET was performed in 38 patients and DCE-MRI in 36 patients. Median OS was 13.4 months, median PFS was 5.9 months. Until January 2012, tissue specimens from 25 patients have been genetically analysed. First results show that even patients with KRAS, PI3K and BRAF mutations profiting from the combination either by response or prolonged PFS could be identified by early imaging assessment. Conclusions: The efficacy of E +B in unselected patients with NSCLC was comparable with platinum-based chemotherapy. In order to identify imaging-based predictive biomarkers to identify the subpopulation of patients with pronounced benefit of this combination FDG-, FLT- PET and DCE–MRI were successfully implemented in the treatment plan. Results of the imaging analysis and the correlation with tissue-based biomarkers will be presented.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.7603
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
detail.hit.zdb_id:
604914-X
