Clinical significance of VEGFR-2 and 18F-FDG PET/CT SUVmax pretreatment score in predicting the long-term outcome of patients with locally advanced rectal cancer treated with neoadjuvant therapy

European Journal of Nuclear Medicine - Tập 40 - Trang 1635-1644 - 2013
Claudio V. Sole1,2,3,4, Felipe A. Calvo1,2,3, Emilio Alvarez2,5,3, Isabel Peligros2,5,3, Pilar Garcia-Alfonso6,3, Carlos Ferrer7, Enrique Ochoa7, Rafael Herranz8,3, Jose L. Carreras2,9
1Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
2School of Medicine, Complutense University, Madrid, Spain
3Institute for Sanitary Research, Hospital General Universitario Gregorio Marañón, Madrid, Spain
4Hospital General Universitario Gregorio Marañon, Madrid, Spain
5Department of Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
6Service of Medical Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
7Institute of Oncology, Hospital Provincial de Castellon, Castellon de la Plana, Spain
8Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
9Department of Radiology and Medical Physics, Hospital General Universitario Gregorio Marañón, Madrid, Spain

Tóm tắt

Vascular endothelial growth factor receptor-2 (VEGFR-2), epidermal growth factor receptor-1 (EGFR), and cyclooxygenase-2 (COX-2) stimulate key processes involved in tumor progression and are important targets for cancer drugs. 18F-FDG maximum standardized uptake value (SUVmax) is a marker of tumor metabolic activity. The purpose of this study was to measure SUVmax combined with VEGFR-2, EGFR and COX-2 proteins in pretreatment tumor biopsies from patients with locally advanced rectal cancer receiving intensive neoadjuvant treatment and to correlate the findings with clinical outcome. VEGFR-2, EGFR and COX-2 were measured using the immunoreactive score (IRS). SUVmax (median 8.4) was quantified in tumors with molecular overexpression (IRS ≥3 + SUVmax ≥ 8.4 indicating active tumors; SUVmax <8.4 indicating inactive tumors). The Cox proportional hazards model was used to explore associations between tumor markers, disease-free survival (DFS) and overall survival (OS). The study group comprised 38 patients with a median follow-up of 69.3 months (range 4.5 – 92 months). Multivariate analysis showed that active tumors (overexpressing VEGFR-2, high SUVmax) were associated with worse DFS (HR 4.73, 95 % CI 1.18  – 22.17; p = 0.04) and OS (HR 4.28, 95 % CI 1.04 – 20.12; p = 0.05). Active tumors overexpressing VEGFR-2 are associated with a worse overall outcome in patients with rectal cancer treated with induction chemotherapy followed by pelvic chemoradiation and surgery. The optimal diagnostic cut-off level for this novel biomarker association should be investigated. Evaluation in a clinical trial is required to determine whether selected patients could benefit from a VEGFR-targeting drug.

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European Journal of Nuclear Medicine

Tập 40

1635-1644

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