H. Manning
Faculty Member
Last active: 3/22/2018

[(18)F]-FLT PET to predict early response to neoadjuvant therapy in KRAS wild-type rectal cancer: a pilot study.

McKinley ET, Watchmaker JM, Chakravarthy AB, Meyerhardt JA, Engelman JA, Walker RC, Washington MK, Coffey RJ, Manning HC
Ann Nucl Med. 2015 29 (6): 535-42

PMID: 25899481 · PMCID: PMC4503488 · DOI:10.1007/s12149-015-0974-6

OBJECT - This pilot study evaluated the utility of 3'-deoxy-3'[18F]-fluorothymidine ([(18)F]-FLT) positron emission tomography (PET) to predict response to neoadjuvant therapy that included cetuximab in patients with wild-type KRAS rectal cancers.

METHODS - Baseline [(18)F]-FLT PET was collected prior to treatment initiation. Follow-up [(18)F]-FLT was collected after three weekly infusions of cetuximab, and following a combined regimen of cetuximab, 5-FU, and radiation. Imaging-matched biopsies were collected with each PET study.

RESULTS - Diminished [(18)F]-FLT PET was observed in 3/4 of patients following cetuximab treatment alone and in all patients following combination therapy. Reduced [(18)F]-FLT PET following combination therapy predicted disease-free status at surgery. Overall, [(18)F]-FLT PET agreed with Ki67 immunoreactivity from biopsy samples and surgically resected tissue, and was predictive of treatment-induced rise in p27 levels.

CONCLUSION - These results suggest that [(18)F]-FLT PET is a promising imaging biomarker to predict response to neoadjuvant therapy that included EGFR blockade with cetuximab in patients with rectal cancer.

MeSH Terms (20)

Adult Antineoplastic Agents Cetuximab Chemoradiotherapy Dideoxynucleosides Female Follow-Up Studies Humans Immunohistochemistry Male Middle Aged Multimodal Imaging Neoadjuvant Therapy Pilot Projects Positron-Emission Tomography Proto-Oncogene Proteins p21(ras) Radiopharmaceuticals Rectal Neoplasms Tomography, X-Ray Computed Treatment Outcome

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