晚期非小细胞肺癌11C-PD153035 PET／CT指导靶向治疗的研究

目的：通过11C—PD153035PET／CT分子影像检测晚期非小细胞肺癌（NSCLC）肿瘤纽织的表皮生长因子受体（EGFR）状态，为EGFR靶向治疗患者的选择与疗效评价等提供新型、有效的影像学手段。方法：经组织学确诊的21例晚期NSCLC患者（11IB～Ⅳ期），接受EGFR靶向治疗（厄罗替尼）前1周内行11C—PD153035PET／CT检查，测定其基准参数最大标准摄取值（SUVmax）。口服厄罗替尼150mg／d，服药6周再次行11C—PD153035PET／CT检查，获取治疗旱期的SUVmax并评价疗效。ROC曲线确定治疗有反应和无反应者的SUV最佳界值。结果：治疗前SUVmax能够预测患者生存，高代谢组（SUVmax〉2．46）的中位生存期（11．7个月）与低代谢组（SUVmax≤2．46）中位生存期（4．9个月）之间差异有统计学意义，P=0．004。21例患者治疗前与治疗6周时SUVmax值比较差异无统计学意义，t=1．31，P=0．209。结论：11C～PD153035作为一种新型示踪刺，通过PET／CT分子影像来检测晚期NSCLC肿瘤组织的EGFR状态，为EGFR靶向治疗的患者筛选和预后预测提供可能。

Molecular Imaging with 11C-PD153035 PET/CT to EGFR-TKI in advanced non-small cell lung cancer

OBJECTIVE： To examines the predictive value of positron emission tomography （PET） using 11C labeled-4-N- （3-bromoanilino）-6, 7-dimenthoxyqu nazoline （ 11C-PD15a035 ）, an imaging biomarker of EGFR-selective TKI, in advanced NSCLC patients treated with erlotinib. METHODS： Twenty- one patients with advance NSCLC（ I]I B-- IV） treated with erlotinib at a dose of 150 mg daily were prospectively studied with nC-PD153035 PET/CT at baseline and after 6 weeks from start of treatment. Receiver operating characteristic （ROC） curves analysis was used to identify the optimum cutoff value of the tumor PD153035 uptake for differentiation of treatment re- sponding and non-responding patients and determine whether these data was predictive of patient outcome. RESULTS： Pa tients with higher SUV group survived more than two times as long as patients with lower SUV group （11. 7 months vs 4. 9 months,P= 0. 004）. However, 11 C-PD153035 uptake was no significant difference between baseline and the follow-up scan （t= 1.81 ,P=0. 209）. CONCLUSION： Our preliminary results suggest the 1i C-PD153035 PET/CT can be used as a noninva sive and rapid method for early selecting EGFR TKI sensitive tumors and predicting outcome of advanced NSCLC with EG- FR-TKI.