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European Journal of Nuclear Medicine and Molecular Imaging

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01-10-2013 | Original Article

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

Authors: Claudio V. Sole, Felipe A. Calvo, Emilio Alvarez, Isabel Peligros, Pilar Garcia-Alfonso, Carlos Ferrer, Enrique Ochoa, Rafael Herranz, Jose L. Carreras

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2013

Abstract

Purpose

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.

Methods

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).

Results

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).

Conclusion

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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Title: 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
Authors: Claudio V. Sole
Felipe A. Calvo
Emilio Alvarez
Isabel Peligros
Pilar Garcia-Alfonso
Carlos Ferrer
Enrique Ochoa
Rafael Herranz
Jose L. Carreras
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2479-7

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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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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