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World J Respirol. Nov 28, 2013; 3(3): 104-109
Published online Nov 28, 2013. doi: 10.5320/wjr.v3.i3.104
FDG-PET for predicting efficacy of EGFR-tyrosine kinase inhibitors in lung cancer
Noriaki Sunaga, Kyoichi Kaira, Takeshi Hisada, Masanobu Yamada
Noriaki Sunaga, Kyoichi Kaira, Takeshi Hisada, Masanobu Yamada, Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan
Author contributions: Sunaga N contributed to conception and design, acquisition of data and analysis; Sunaga N, Kaira K, Hisada T and Yamada M contributed to interpretation of data.
Supported by Grants-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science, No. #23591134
Correspondence to: Noriaki Sunaga, MD, Department of Medicine and Molecular Science, Gunma University Graduat School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma 371-8511, Japan. nsunaga@gunma-u.ac.jp
Telephone: +81-27-2208136 Fax: +81-27-2208136
Received: June 26, 2013
Revised: July 12, 2013
Accepted: July 17, 2013
Published online: November 28, 2013
Processing time: 159 Days and 20.7 Hours
Abstract

Non-small cell lung cancer (NSCLC) is the major cause of cancer-related deaths worldwide. Recent advances in molecular biology have resulted in the clinical use of several molecularly targeted drugs, which usually exhibit cytostatic antitumor activity, to improve the survival of NSCLC patients. The epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) gefitinib and erlotinib have been approved for the treatment of NSCLC, and several phase III trials have demonstrated that sensitizing EGFR mutations are biomarkers for predicting a favorable clinical outcome of NSCLC patients treated with the EGFR-TKIs. The Response Evaluation Criteria in Solid Tumors is generally used to assess the therapeutic response to antitumor drugs based on the morphological changes in tumor size as evaluated by computed tomography or magnetic resonance imaging. However, such assessment may not always reflect the treatment efficacy of cytostatic drugs, such as EGFR-TKIs. In this regard, functional imaging methods, including 18F-fluorodeoxyglucose measured by positron emission tomography (FDG-PET), are potentially beneficial. An increasing body of evidence indicates the usefulness of FDG-PET to predict treatment efficacy for NSCLC patients treated with EGFR-TKIs. In this review, we summarize the current understanding of the potential role of FDG-PET in the clinical use of EGFR-TKIs for NSCLC.

Keywords: Non-small cell lung cancer; 18F-fluorodeoxyglucose measured by positron emission tomography; Epidermal growth factor receptor mutation; Gefitinib; Erlotinib; Survival; Biomarker

Core tip: Molecularly targeted drugs including epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), which usually exhibit cytostatic antitumor activity, have emerged for the treatment of non-small cell lung cancer. The Response Evaluation Criteria in Solid Tumors is generally used to assess the therapeutic response based on the morphological changes in tumor size as evaluated by computed tomography or magnetic resonance imaging. However, such assessment may not always reflect the clinical outcome of cytostatic drugs, such as EGFR-TKIs. In this regard, 18F-fluorodeoxyglucose measured by positron emission tomography (FDG-PET) is potentially beneficial. Here we summarize the role of FDG-PET to predict the treatment efficacy in NSCLC treated with EGFR-TKIs.