PET imaging of patients with non-small cell lung cancer employing an EGF receptor targeting drug as tracer

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Abstract

Background: We have previously developed 11 C-erlotinib as a new positron emission tomography (PET) tracer and shown that it accumulates in epidermal growth factor receptor (EGFR)-positive lung cancer xenografts in mice. Here, we present a study in patients with non-small cell lung cancer (NSCLC) investigating the feasibility of 11 C-erlotinib PET as a potential method for the identification of lung tumours accumulating erlotinib. Methods: Thirteen patients with NSCLC destined for erlotinib treatment were examined by contrast-enhanced computed tomography (CT), 11 C-erlotinib PET/low-dose CT and 18 F-fluoro-2-deoxy-D-glucose (18 F-FDG) PET/low-dose CT before start of the erlotinib treatment. After 12 weeks treatment, they were examined by 18 F-FDG PET/contrast-enhanced CT for the assessment of clinical response. Results: Of the 13 patients included, 4 accumulated 11 C-erlotinib in one or more of their lung tumours or lymph-node metastases. Moreover, 11 C-erlotinib PET/CT identified lesions that were not visible on 18 F-FDG PET/CT. Of the four patients with accumulation of 11 C-erlotinib, one died before follow-up, whereas the other three showed a positive response to erlotinib treatment. Three of the nine patients with no accumulation died before follow-up, four showed progressive disease while two had stable disease after 12 weeks of treatment. Conclusion: Our data show a potential for 11 C-erlotinib PET/CT for visualizing NSCLC lung tumours, including lymph nodes not identified by 18 F-FDG PET/CT. Large clinical studies are now needed to explore to which extent pre-treatment 11 C-erlotinib PET/CT can predict erlotinib treatment response. © 2011 Cancer Research UK All rights reserved.

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Memon, A. A., Weber, B., Winterdahl, M., Jakobsen, S., Meldgaard, P., Madsen, H. H. T., … Sorensen, B. S. (2011). PET imaging of patients with non-small cell lung cancer employing an EGF receptor targeting drug as tracer. British Journal of Cancer, 105(12), 1850–1855. https://doi.org/10.1038/bjc.2011.493

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