[18F]-FDG-PET/CT Correlates With the Response of Radiorefractory Thyroid Cancer to Lenvatinib and Patient Survival.

Abstract

CONTEXT:

18F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography ([18F]-FDG-PET/CT)-positive metastatic lesions in radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) have a poor prognosis and lenvatinib represents the best therapy.

OBJECTIVE:

We investigated the role of [18F]-FDG-PET/CT in the evaluation of metabolic response and prediction of the outcome of RAI-R DTC patients treated with lenvatinib.

METHODS:

Patients (n = 33) with progressive metastatic RAI-R DTC who were treated with lenvatinib were investigated at baseline and during follow-up with biochemical (thyroglobulin and thyroglobulin antibodies), morphological (whole-body CT scan) and metabolic ([18F]-FDG-PET/CT) evaluation.

RESULTS:

Nineteen (57.6%) patients showed the greatest metabolic response at the first [18F]-FDG-PET/CT scan, performed after 4 weeks of lenvatinib, while 5/33 (15.1%) patients had this response later. Moreover, 66.7% of patients had both a metabolic response at the first [18F]-FDG-PET/CT scan and a morphological response at the first CT scan. We observed a correlation between the metabolic response at [18F]-FDG-PET/CT scan performed after 4 weeks of treatment and the biochemical response at the same time in 60.6% of patients. The median overall survival (OS) was significantly longer in patients with either a metabolic response at last [18F]-FDG-PET/CT (40.00 vs 8.98 months) or a morphological response at last CT scan (37.22 vs 9.53 months) than in those without response. Moreover, the OS was longer in patients with a metabolic response at [18F]-FDG-PET/CT performed after 4 weeks of treatment (36.53 vs 11.28 months).

CONCLUSIONS:

Our data show that [18F]-FDG-PET/CT can early predict the response to lenvatinib and correlates with the OS of RAI-R DTC patients treated with this drug.

• Authors: Laura Valerio, Federica Guidoccio, Carlotta Giani, Elisa Tardelli, Giulia Puccini, Luciana Puleo, Elisa Minaldi, Giuseppe Boni, Rossella Elisei, Duccio Volterrani
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 106 Issue 8 Pg. 2355-2366 (07 13 2021) ISSN: 1945-7197 [Electronic] United States
• PMID: 33901285 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Antineoplastic Agents
• Iodine Radioisotopes
• Phenylurea Compounds
• Quinolines
• Fluorodeoxyglucose F18
• lenvatinib

Topics

• Adenocarcinoma, Follicular (diagnostic imaging, drug therapy, mortality)
• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Female
• Fluorodeoxyglucose F18
• Humans
• Iodine Radioisotopes
• Male
• Middle Aged
• Phenylurea Compounds (therapeutic use)
• Positron Emission Tomography Computed Tomography
• Quinolines (therapeutic use)
• Survival Rate
• Thyroid Neoplasms (diagnostic imaging, drug therapy, mortality)
• Tomography, X-Ray Computed
• Treatment Outcome
• Whole Body Imaging