Evaluation of early response to SU101 target-based therapy in patients with recurrent supratentorial malignant gliomas using FDG PET and Gd-DTPA MRI Journal Article

  

Authors:	Vlassenko, A. G.; Thiessen, B.; Beattie, B. J.; Malkin, M. G.; Blasberg, R. G.
Article Title:	Evaluation of early response to SU101 target-based therapy in patients with recurrent supratentorial malignant gliomas using FDG PET and Gd-DTPA MRI
Abstract:	Changes in [18F]-2-fluoro-2-deoxyglucose (FDG) uptake and gadopentetate dimeglumine (Gd-DTPA) enhancement before and after the first course of treatment with a cytostatic agent SU101 (N-[(4-trifluoromethyl)-phenyl]-5-methylisoxasole-4-carboxamide, SUGEN) were assessed using positron emission tomography (PET) and magnetic resonance imaging (MRI) in a pilot study of 8 patients with recurrent supratentorial malignant gliomas. The localization and the volume of Gd-DTPA enhancement and FDG hypermetabolism were analyzed. PET and MRI studies were performed one week before and 7.6 ± 3.7 weeks after administration of SU101. The ratios of mean tumor activity to mean contralateral white matter and ipsilateral cerebellar activity were calculated for tumor regions, and SUV values corrected to the subjects' body surface area and glucose level (SUVbsa*glu) were calculated for non-tumor regions. Five patients had a substantial increase of tumor volume on both PET and MRI during the first course of SU101. PET and MRI showed roughly equivalent volume changes. Large tumor volume increases were associated with a short time to clinical progression. The metabolic change in the tumor following the first course of SU101 varied from patient to patient, ranging from a 31% reduction to a 43% increase in FDG uptake ratio. Changes in FDG uptake were not predictive of time to progression or survival. In 2 patients with marked clinical deterioration and rapid tumor growth, there were differences in localization of Gd-DTPA enhancement and FDG hypermetabolism suggesting that hypermetabolism beyond the area of contrast enhancement may be of value in predicting rapid progression of high-grade glioma. SU101 did not induce any appreciable changes in SUVbsa*glu for non-tumor brain in 6 of 8 patients.
Keywords:	signal transduction; adult; clinical article; treatment outcome; disease-free survival; middle aged; antineoplastic agents; chemotherapy, adjuvant; combined modality therapy; nuclear magnetic resonance imaging; positron emission tomography; brain tumor; magnetic resonance imaging; neoplasm recurrence, local; tumor volume; antineoplastic combined chemotherapy protocols; diagnostic imaging; carmustine; cranial irradiation; pilot study; disease progression; tumor recurrence; glioblastoma; platelet-derived growth factor; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; glioblastoma multiforme; supratentorial neoplasms; glucose; drug monitoring; tumor growth; gadolinium dtpa; astrocytoma; energy metabolism; tomography, emission-computed; isoxazoles; gadolinium pentetate meglumine; anaplastic astrocytoma; biological transport, active; leflunomide; humans; prognosis; human; male; female; article; [18f]-2-fluoro-2-deoxyglucose; su101
Journal Title:	Journal of Neuro-Oncology
Volume:	46
Issue:	3
ISSN:	0167-594X
Publisher:	Springer
Date Published:	2000-02-01
Start Page:	249
End Page:	259
Language:	English
DOI:	10.1023/a:1006481313747
PUBMED:	10902856
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-0034085545&partnerID=40&md5=171483b7ce459f51541d3f25437fcfa9
Notes:	Export Date: 18 November 2015 -- Source: Scopus

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