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European Journal of Nuclear Medicine and Molecular Imaging

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01-11-2014 | Original Article

Role of [¹⁸F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

Authors: Carlos Caicedo, Maria Jose Garcia-Velloso, Maria Dolores Lozano, Tania Labiano, Carmen Vigil Diaz, Jose Maria Lopez-Picazo, Alfonso Gurpide, Javier Zulueta, Jose Angel Richter Echevarria, Jose Luis Perez Gracia

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2014

Abstract

Purpose

The tumour molecular profile predicts the activity of epidermal growth factor receptor (EGFR) inhibitors in non-small-cell lung cancer (NSCLC). However, tissue availability and tumour heterogeneity limit its assessment. We evaluated whether [¹⁸F]FDG PET might help predict KRAS and EFGR mutation status in NSCLC.

Methods

Between January 2005 and October 2011, 340 NSCLC patients were tested for KRAS and EGFR mutation status. We identified patients with stage III and IV disease who had undergone [¹⁸F]FDG PET/CT scanning for initial staging. SUVpeak, SUVmax and SUVmean of the single hottest tumour lesions were calculated, and their association with KRAS and EGFR mutation status was assessed. A receiver operator characteristic (ROC) curve analysis and a multivariate analysis (including SUVmean, gender, age and AJCC stage) were performed to identify the potential value of [¹⁸F]FDG PET/CT for predicting KRAS mutation.

Results

From 102 patients staged using [¹⁸F]FDG PET/CT, 28 (27 %) had KRAS mutation (KRAS+), 22 (22 %) had EGFR mutation (EGFR+) and 52 (51 %) had wild-type KRAS and EGFR profiles (WT). KRAS+ patients showed significantly higher [¹⁸F]FDG uptake than EGFR+ and WT patients (SUVmean 9.5, 5.7 and 6.6, respectively; p < 0.001). No significant differences were observed in [¹⁸F]FDG uptake between EGFR+ patients and WT patients. ROC curve analysis for KRAS mutation status discrimination yielded an area under the curve of 0.740 for SUVmean (p < 0.001). The multivariate analysis showed a sensitivity and specificity of 78.6 % and 62.2 %, respectively, and the AUC was 0.773.

Conclusion

NSCLC patients with tumours harbouring KRAS mutations showed significantly higher [¹⁸F]FDG uptake than WT patients, as assessed in terms of SUVpeak, SUVmax and SUVmean. A multivariate model based on age, gender, AJCC stage and SUVmean might be used as a predictive marker of KRAS mutation status in patients with stage III or IV NSCLC.

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Title: Role of [18F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer
Authors: Carlos Caicedo
Maria Jose Garcia-Velloso
Maria Dolores Lozano
Tania Labiano
Carmen Vigil Diaz
Jose Maria Lopez-Picazo
Alfonso Gurpide
Javier Zulueta
Jose Angel Richter Echevarria
Jose Luis Perez Gracia
Publication date: 01-11-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-014-2833-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Role of [¹⁸F]FDG PET in prediction of KRAS and EGFR mutation status in patients with advanced non-small-cell lung cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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