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DOI: 10.1055/s-0040-1708347
Prediction of treatment response to lenvatinib with FDG-PET/CT in patients with advanced thyroid carcinoma
Publication History
Publication Date:
08 April 2020 (online)
Ziel/Aim In patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC), Lenvatinib is a promising treatment option for prolonged progression free survival. We aimed to assess the prognostic value of metabolic imaging using 18-F-FDG-PET/CT shortly before and in the first follow up of lenvatinib therapy.
Methodik/Methods Patients with RR-DTC who underwent baseline FDG-PET/CT shortly before and within 6 months after initiation of the treatment were included. PET/CT parameters (SUVmax/mean/peak, tumor volume, total lesion glycolysis) as well as clinical parameters (age, sex, TNM-classification, mean total radioiodine dose) were assessed. Treatment response was evaluated according to PET Response Criteria in Solid Tumors (PERCIST) as well as Response Evaluation Criteria in Solid Tumors 1.1 (RECIST) and correlated with clinical outcome (disease-specific survival, DSS) using Kaplan-Meier-Survival analysis.
Ergebnisse/Results 21 patients met the inclusion criteria. Within a median follow up time of 37 months, 11 patients died (DSS 26 months (estimated median; median not reached)). According to PERCIST criteria 6/21 showed complete remission (CR), 5/21 partial remission (PR), 5/21 stable disease (SD), 3/21 progressive disease (PD) and two subjects did not show a measurable FDG-uptake prior or after treatment. According to RECIST criteria 0/21 showed CR, 2/21 PR, 16/21 SD and 3/21 PD. DSS did not differ among groups of subjects with CR/PR, SD or PD neither according to RECIST nor PRECIST criteria (all p >0.05). None of the investigated clinical or PET/CT parameters correlated significantly with the DSS.
Schlussfolgerungen/Conclusions Treatment evaluation with FDG-PET/CT prior and after initiation of lenvatinib treatment cannot predict the DSS in patients with RR-DTC (as shown in the SELECT study). No other contributing clinical parameters on the DSS were found. The further analysis of possible prediction of progression free survival is pending.