16125
2018
eng
article
1
2018-04-29
--
--
Predictive value of \(^{18}\)F-FDG PET in patients with advanced medullary thyroid carcinoma treated with vandetanib
Introduction: Therapeutic options in advanced medullary thyroid carcinoma (MTC) have markedly improved since the introduction of tyrosine kinase inhibitors (TKI). We
aimed to assess the role of metabolic imaging using 2-deoxy-2-(\(^{18}\)F)fluoro-D-glucose (\(^{18}\)F-FDG) positron emission tomography/computed tomography (PET/CT) shortly before and 3 months after initiation of TKI treatment.
Methods: Eighteen patients with advanced and progressive MTC scheduled for vandetanib treatment underwent baseline \(^{18}\)F-FDG PET/CT prior to and 3 months after TKI treatment initiation. During follow-up, CT scans were performed every 3 months and analyzed according to Response Evaluation Criteria In Solid Tumors (RECIST). The predictive value for estimating progression-free (PFS) and overall survival (OS) was examined by investigating \(^{18}\)F-FDG mean/maximum standardized uptake values (SUVmean/max) of the metabolically most active lesion as well as by analyzing clinical parameters (tumor marker doubling times {calcitonin, carcinoembryonic antigen (CEA)}, prior therapies, RET (rearranged during transfection) mutational status, and disease type).
Results: Within a median follow-up of 5.2 years, 9 patients experienced disease progression after a median time interval of 2.1y whereas the remainder had ongoing disease control (n=5 partial response and n=4 stable disease). Eight of the 9 patients with progressive disease died from MTC after a median of 3.5y after TKI initiation.
Pre-therapeutic SUVmean >4.0 predicted a significantly shorter PFS (PFS: 1.9y vs. 5.2y; p=0.04). Furthermore, sustained high 18F-FDG uptake at 3 months with a SUVmean>2.8 tended to portend an unfavorable prognosis with a PFS of 1.9y (vs. 3.5y; p=0.3). Prolonged CEA doubling times were significantly correlated with longer PFS (r=0.7) and OS (r=0.76, p<0.01, respectively). None of the other clinical parameters had prognostic significance.
Conclusions: Pre-therapeutic \(^{18}\)F-FDG PET/CT holds prognostic information in patients with advanced MTC scheduled for treatment with the TKI vandetanib. Low tumor metabolism of SUVmean < 4.0 prior to treatment predicts longer progression-free survival.
Journal of Nuclear Medicine
10.2967/jnumed.117.199778
0161-5505
https://www.ncbi.nlm.nih.gov/pubmed/29025983
urn:nbn:de:bvb:20-opus-161256
This research was originally published in JNM. Rudolf A. Werner, Jan-Stefan Schmid, Takahiro Higuchi, Mehrbod S. Javadi, Steven P. Rowe, Bruno Märkl, Christoph Aulmann, Martin Fassnacht, Matthias Kroiss, Christoph Reiners, Andreas K. Buck, Michael C. Kreissl, Constantin Lapa. Predictive value of 18F-FDG PET in patients with advanced medullary thyroid carcinoma treated with vandetanib. J Nucl Med. May 1, 2018;vol. 59 no. 5: 756-761. © SNMMI.
Johns Hopkins University School of Medicine
Journal of Nuclear Medicine May 1, 2018 vol. 59 no. 5 756-761. doi:10.2967/jnumed.117.199778
701983
Deutsches Urheberrecht
Rudolf Werner
Jan-Stefan Schmid
Takahiro Higuchi
Mehrbod S. Javadi
Steven P. Rowe
Bruno Märkl
Christoph Aulmann
Martin Fassnacht
Matthias Kroiß
Christoph Reiners
Andreas Buck
Michael Kreissl
Constantin Lapa
eng
uncontrolled
positron emission tomography
deu
swd
Medullärer Schilddrüsenkrebs
deu
swd
Positronen-Emissions-Tomografie
eng
uncontrolled
medullary thyroid carcinoma
eng
uncontrolled
tyrosine kinase inhibitor
eng
uncontrolled
vandetanib
eng
uncontrolled
2- deoxy-2-(18F)fluoro-D-glucose
eng
uncontrolled
18F-FDG
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
Medizinische Klinik und Poliklinik I
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16125/Werner_Rudolf_Vandetanib_JNM_accepted_version.pdf
16114
2017
eng
169
no. supplement 1
58
conferenceobject
1
2018-04-25
--
--
Predictive value of FDG-PET in patients with advanced medullary thyroid cancer undergoing vandetanib treatment
Introduction: The prognosis of medullary thyroid carcinoma (MTC) is poor using common chemotherapeutic approaches. However, during the last years encouraging results of recently introduced tyrosine kinase inhibitors (TKI) such as vandetanib have been published. In this study we aimed to correlate the results of \(^{18}\)F-fluorodeoxyglucose ([\(^{18}\)F]FDG) positron emission tomography (PET) imaging with treatment outcome.
Methods: Eighteen patients after thyroidectomy with recurrent/advanced MTC lesions receiving vandetanib (300 mg orally/day) could be analysed. A baseline \(^{18}\)F-FDG PET prior to and a follow-up \(^{18}\)F-FDG PET 3 months after TKI initiation were performed. During follow-up, tumor progression was assessed every 3 months including computed tomography according to RECIST. Progression-free survival (PFS) was correlated with the maximum standardized uptake value of \(^{18}\)F-FDG in lymph nodes (SUV(LN)max) or visceral metastases (SUV(MTS)max) as well as with clinical parameters using ROC analysis.
Results: Within median 3.6 years of follow-up, 9 patients showed disease progression at median 8.5 months after TKI initiation. An elevated glucose consumption assessed by baseline \(^{18}\)F-FDG PET (SUV(LN)max > 7.25) could predict a shorter PFS (2 y) with an accuracy of 76.5% (SUV(LN)max <7.25, 4.3 y; p=0.03). Accordingly, preserved tumor metabolism in the follow-up PET (SUV(MTS)max >2.7) also demonstrated an unfavorable prognosis (accuracy, 85.7%). On the other hand, none of the clinical parameters reached significance in response prediction.
Conclusions: In patients with advanced and progressive MTC, tumors with higher metabolic activity at baseline are more aggressive and more prone to progression as reflected by a shorter PFS; they should be monitored more closely. Preserved glucose consumption 3 months after treatment initiation was also related to poorer prognosis.
Journal of Nuclear Medicine
0161-5505
http://jnm.snmjournals.org/content/58/supplement_1/169
urn:nbn:de:bvb:20-opus-161147
This research was originally published in JNM.
Rudolf A. Werner, Takahiro Higuchi, Dirk O. Muegge, Mehrbod S. Javadi, B. Märkl, C. Aulmann, Andreas K. Buck, Martin Fassnacht, Constantin Lapa, Michael C. Kreissl.
Predictive value of FDG-PET in patients with advanced medullary thyroid cancer undergoing vandetanib treatment. J Nucl Med. May 1, 2017; vol. 58 no. supplement 1:169. © SNMMI.
Johns Hopkins School of Medicine, Baltimore, MD, U.S.
Hospital Augsburg, Augsburg, Germany
Journal of Nuclear Medicine May 1, 2017 vol. 58 no. supplement 1 169
701983
Deutsches Urheberrecht
Rudolf Werner
Takahiro Higuchi
Dirk Muegge
Mehrbod S. Javadi
Bruno Märkl
Christoph Aulmann
Andreas K. Buck
Martin Fassnacht
Constantin Lapa
Michael C. Kreissl
eng
uncontrolled
18F-FDG
eng
uncontrolled
vandetanib
eng
uncontrolled
TKI
eng
uncontrolled
PET
eng
uncontrolled
positron emission tomography
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Nuklearmedizin
Medizinische Klinik und Poliklinik I
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16114/Werner_Rudolf_Vandetanib_Kongressbeitrag_accepted_version.pdf
29031
2022
eng
20
14
article
1
--
2022-10-14
--
Identification of disparities in personalized cancer care — a joint approach of the German WERA consortium
(1) Background: molecular tumor boards (MTBs) are crucial instruments for discussing and allocating targeted therapies to suitable cancer patients based on genetic findings. Currently, limited evidence is available regarding the regional impact and the outreach component of MTBs; (2) Methods: we analyzed MTB patient data from four neighboring Bavarian tertiary care oncology centers in Würzburg, Erlangen, Regensburg, and Augsburg, together constituting the WERA Alliance. Absolute patient numbers and regional distribution across the WERA-wide catchment area were weighted with local population densities; (3) Results: the highest MTB patient numbers were found close to the four cancer centers. However, peaks in absolute patient numbers were also detected in more distant and rural areas. Moreover, weighting absolute numbers with local population density allowed for identifying so-called white spots—regions within our catchment that were relatively underrepresented in WERA MTBs; (4) Conclusions: investigating patient data from four neighboring cancer centers, we comprehensively assessed the regional impact of our MTBs. The results confirmed the success of existing collaborative structures with our regional partners. Additionally, our results help identifying potential white spots in providing precision oncology and help establishing a joint WERA-wide outreach strategy.
Cancers
2072-6694
10.3390/cancers14205040
urn:nbn:de:bvb:20-opus-290311
2022-11-04T10:35:19+00:00
sword
swordwue
attachment; filename=deposit.zip
8fd129ff70a63ae0c6bdbde45ab3f48b
Cancers (2022) 14:20, 5040. https://doi.org/10.3390/cancers14205040
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Florian Lüke
Florian Haller
Kirsten Utpatel
Markus Krebs
Norbert Meidenbauer
Alexander Scheiter
Silvia Spoerl
Daniel Heudobler
Daniela Sparrer
Ulrich Kaiser
Felix Keil
Christoph Schubart
Lars Tögel
Sabine Einhell
Wolfgang Dietmaier
Ralf Huss
Sebastian Dintner
Sebastian Sommer
Frank Jordan
Maria-Elisabeth Goebeler
Michaela Metz
Diana Haake
Mithun Scheytt
Elena Gerhard-Hartmann
Katja Maurus
Stephanie Brändlein
Andreas Rosenwald
Arndt Hartmann
Bruno Märkl
Hermann Einsele
Andreas Mackensen
Wolfgang Herr
Volker Kunzmann
Ralf Bargou
Matthias W. Beckmann
Tobias Pukrop
Martin Trepel
Matthias Evert
Rainer Claus
Alexander Kerscher
eng
uncontrolled
precision oncology
eng
uncontrolled
MTB
eng
uncontrolled
patient access
eng
uncontrolled
cancer care
eng
uncontrolled
outreach
eng
uncontrolled
real world data
eng
uncontrolled
outcomes research
Medizin und Gesundheit
open_access
Urologische Klinik und Poliklinik
Pathologisches Institut
Medizinische Klinik und Poliklinik II
Import
Comprehensive Cancer Center Mainfranken
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/29031/cancers-14-05040-v2.pdf