Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition

Gerald S.M.A. Kerner, Michel J.B. Koole, Alphons H.H. Bongaerts, Jan Pruim, H. J.M. Groen, G. Van Dongen, E. Caldenhoven, V. M.H. Coupé, A. Fischer, H. J.M. Groen, L. Perk, M. Van Herk, P. H. Elsinga, P. Lambin, R. H. Brakenhoff, R. Boellaard, C. Uyl, W. Van Criekinge, CTMM Air Force Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: In ALK-positive advanced NSCLC, crizotinib has a high response rate and effectively increases quality of life and survival. CT measurement of the tumor may insufficiently reflect the actual tumor load changes during targeted therapy with crizotinib. We explored whether 18F-FDG PET measured metabolic changes are different from CT based changes and studied the impact of these changes on disease progression. Methods: 18F-FDG PET/CT was performed prior to and after 6 weeks of crizotinib treatment. Tumor response on CT was classified with RECIST 1.1, while 18F-FDG PET response was assessed according to the 1999 EORTC recommendations and PERCIST criteria. Agreement was assessed using McNemars test. During follow-up, patients received additional PET/CT during crizotinib treatment and second generation ALK inhibition. We assessed whether PET was able to detect progression earlier then CT. Results: In this exploratory study 15 patients were analyzed who were treated with crizotinib. There was a good agreement in the applicability of CT and 18F-FDG PET/CT using the EORTC recommendations. During first line crizotinib and subsequent second line ALK inhibitors, PET was able to detect progression earlier then CT in 10/22 (45%) events of progression and in the others disease progression was detected simultaneously. Conclusion: In advanced ALK positive NSCLC PET was able to detect progressive disease earlier than with CT in nearly half of the assessments while both imaging tests performed similar in the others.

Original languageEnglish
Article numbere0149955
JournalPLoS ONE
Volume11
Issue number5
DOIs
Publication statusPublished - 1 May 2016

Cite this

Kerner, G. S. M. A., Koole, M. J. B., Bongaerts, A. H. H., Pruim, J., Groen, H. J. M., Van Dongen, G., ... CTMM Air Force Consortium (2016). Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition. PLoS ONE, 11(5), [e0149955]. https://doi.org/10.1371/journal.pone.0149955
Kerner, Gerald S.M.A. ; Koole, Michel J.B. ; Bongaerts, Alphons H.H. ; Pruim, Jan ; Groen, H. J.M. ; Van Dongen, G. ; Caldenhoven, E. ; Coupé, V. M.H. ; Fischer, A. ; Groen, H. J.M. ; Perk, L. ; Van Herk, M. ; Elsinga, P. H. ; Lambin, P. ; Brakenhoff, R. H. ; Boellaard, R. ; Uyl, C. ; Van Criekinge, W. ; CTMM Air Force Consortium. / Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition. In: PLoS ONE. 2016 ; Vol. 11, No. 5.
@article{1c526487845a4f3d940726cc6ed9895a,
title = "Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition",
abstract = "Background: In ALK-positive advanced NSCLC, crizotinib has a high response rate and effectively increases quality of life and survival. CT measurement of the tumor may insufficiently reflect the actual tumor load changes during targeted therapy with crizotinib. We explored whether 18F-FDG PET measured metabolic changes are different from CT based changes and studied the impact of these changes on disease progression. Methods: 18F-FDG PET/CT was performed prior to and after 6 weeks of crizotinib treatment. Tumor response on CT was classified with RECIST 1.1, while 18F-FDG PET response was assessed according to the 1999 EORTC recommendations and PERCIST criteria. Agreement was assessed using McNemars test. During follow-up, patients received additional PET/CT during crizotinib treatment and second generation ALK inhibition. We assessed whether PET was able to detect progression earlier then CT. Results: In this exploratory study 15 patients were analyzed who were treated with crizotinib. There was a good agreement in the applicability of CT and 18F-FDG PET/CT using the EORTC recommendations. During first line crizotinib and subsequent second line ALK inhibitors, PET was able to detect progression earlier then CT in 10/22 (45{\%}) events of progression and in the others disease progression was detected simultaneously. Conclusion: In advanced ALK positive NSCLC PET was able to detect progressive disease earlier than with CT in nearly half of the assessments while both imaging tests performed similar in the others.",
author = "Kerner, {Gerald S.M.A.} and Koole, {Michel J.B.} and Bongaerts, {Alphons H.H.} and Jan Pruim and Groen, {H. J.M.} and {Van Dongen}, G. and E. Caldenhoven and Coup{\'e}, {V. M.H.} and A. Fischer and Groen, {H. J.M.} and L. Perk and {Van Herk}, M. and Elsinga, {P. H.} and P. Lambin and Brakenhoff, {R. H.} and R. Boellaard and C. Uyl and {Van Criekinge}, W. and {CTMM Air Force Consortium}",
year = "2016",
month = "5",
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Kerner, GSMA, Koole, MJB, Bongaerts, AHH, Pruim, J, Groen, HJM, Van Dongen, G, Caldenhoven, E, Coupé, VMH, Fischer, A, Groen, HJM, Perk, L, Van Herk, M, Elsinga, PH, Lambin, P, Brakenhoff, RH, Boellaard, R, Uyl, C, Van Criekinge, W & CTMM Air Force Consortium 2016, 'Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition' PLoS ONE, vol. 11, no. 5, e0149955. https://doi.org/10.1371/journal.pone.0149955

Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition. / Kerner, Gerald S.M.A.; Koole, Michel J.B.; Bongaerts, Alphons H.H.; Pruim, Jan; Groen, H. J.M.; Van Dongen, G.; Caldenhoven, E.; Coupé, V. M.H.; Fischer, A.; Groen, H. J.M.; Perk, L.; Van Herk, M.; Elsinga, P. H.; Lambin, P.; Brakenhoff, R. H.; Boellaard, R.; Uyl, C.; Van Criekinge, W.; CTMM Air Force Consortium.

In: PLoS ONE, Vol. 11, No. 5, e0149955, 01.05.2016.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Total body metabolic tumor response in ALK positive non-small cell lung cancer patients treated with ALK inhibition

AU - Kerner, Gerald S.M.A.

AU - Koole, Michel J.B.

AU - Bongaerts, Alphons H.H.

AU - Pruim, Jan

AU - Groen, H. J.M.

AU - Van Dongen, G.

AU - Caldenhoven, E.

AU - Coupé, V. M.H.

AU - Fischer, A.

AU - Groen, H. J.M.

AU - Perk, L.

AU - Van Herk, M.

AU - Elsinga, P. H.

AU - Lambin, P.

AU - Brakenhoff, R. H.

AU - Boellaard, R.

AU - Uyl, C.

AU - Van Criekinge, W.

AU - CTMM Air Force Consortium

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: In ALK-positive advanced NSCLC, crizotinib has a high response rate and effectively increases quality of life and survival. CT measurement of the tumor may insufficiently reflect the actual tumor load changes during targeted therapy with crizotinib. We explored whether 18F-FDG PET measured metabolic changes are different from CT based changes and studied the impact of these changes on disease progression. Methods: 18F-FDG PET/CT was performed prior to and after 6 weeks of crizotinib treatment. Tumor response on CT was classified with RECIST 1.1, while 18F-FDG PET response was assessed according to the 1999 EORTC recommendations and PERCIST criteria. Agreement was assessed using McNemars test. During follow-up, patients received additional PET/CT during crizotinib treatment and second generation ALK inhibition. We assessed whether PET was able to detect progression earlier then CT. Results: In this exploratory study 15 patients were analyzed who were treated with crizotinib. There was a good agreement in the applicability of CT and 18F-FDG PET/CT using the EORTC recommendations. During first line crizotinib and subsequent second line ALK inhibitors, PET was able to detect progression earlier then CT in 10/22 (45%) events of progression and in the others disease progression was detected simultaneously. Conclusion: In advanced ALK positive NSCLC PET was able to detect progressive disease earlier than with CT in nearly half of the assessments while both imaging tests performed similar in the others.

AB - Background: In ALK-positive advanced NSCLC, crizotinib has a high response rate and effectively increases quality of life and survival. CT measurement of the tumor may insufficiently reflect the actual tumor load changes during targeted therapy with crizotinib. We explored whether 18F-FDG PET measured metabolic changes are different from CT based changes and studied the impact of these changes on disease progression. Methods: 18F-FDG PET/CT was performed prior to and after 6 weeks of crizotinib treatment. Tumor response on CT was classified with RECIST 1.1, while 18F-FDG PET response was assessed according to the 1999 EORTC recommendations and PERCIST criteria. Agreement was assessed using McNemars test. During follow-up, patients received additional PET/CT during crizotinib treatment and second generation ALK inhibition. We assessed whether PET was able to detect progression earlier then CT. Results: In this exploratory study 15 patients were analyzed who were treated with crizotinib. There was a good agreement in the applicability of CT and 18F-FDG PET/CT using the EORTC recommendations. During first line crizotinib and subsequent second line ALK inhibitors, PET was able to detect progression earlier then CT in 10/22 (45%) events of progression and in the others disease progression was detected simultaneously. Conclusion: In advanced ALK positive NSCLC PET was able to detect progressive disease earlier than with CT in nearly half of the assessments while both imaging tests performed similar in the others.

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U2 - 10.1371/journal.pone.0149955

DO - 10.1371/journal.pone.0149955

M3 - Article

VL - 11

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 5

M1 - e0149955

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