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Open Access 01-12-2014 | Research article

Metabolic response by FDG-PET to imatinib correlates with exon 11 KIT mutation and predicts outcome in patients with mucosal melanoma

Authors: Katherine Zukotynski, Jeffrey T Yap, Anita Giobbie-Hurder, Jeffrey Weber, Rene Gonzalez, Thomas F Gajewski, Steven O’Day, Kevin Kim, F Stephen Hodi, Annick D Van den Abbeele

Published in: Cancer Imaging | Issue 1/2014

Abstract

Background

In patients with metastatic melanoma and KIT amplifications and/or mutations, therapy with imatinib mesylate may prolong survival. ¹⁸F-labeled 2-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) PET/CT may be used to assess metabolic response. We investigated associations of metabolic response, mutational status, progression-free survival and overall survival in this population.

Methods

Baseline and 4-week follow-up ¹⁸F-FDG-PET/CT were evaluated in 17 patients with metastatic melanoma and KIT amplifications and/or mutations treated with imatinib in a multicenter phase II clinical trial. The maximum standardized uptake values (SUVmax) were measured in up to 10 lesions on each scan. Metabolic response was classified using modified EORTC criteria. Each patient had a diagnostic CT or MR at baseline, after 6 weeks of therapy and then at intervals of 2 months and anatomic response was classified using RECIST 1.0. Median follow-up was 9.8 months.

Results

Partial metabolic response (PMR), stable metabolic disease (SMD) and progressive metabolic disease (PMD) was seen in 5 (29%), 5 (29%), and 7 (41%) patients respectively. Five patients (29%) had a KIT mutation in exon 11, four of whom (80%) had PMR while 1 (20%) had SMD. Twelve patients (71%) did not have a KIT mutation in exon 11, and only 1 (8%) had PMR, 4 (33%) had SMD and 7 (58%) had PMD. There was agreement of metabolic and anatomic classification in 12 of 17 patients (71%). Four of 17 patients (24%) had PR on both metabolic and anatomic imaging and all had a KIT mutation in exon 11. Survival of patients with PMD was lower than with SMD or PMR.

Conclusions

Metabolic response by ¹⁸F-FDG-PET/CT is associated with mutational status in metastatic melanoma patients treated with imatinib. ¹⁸F-FDG-PET/CT may be a predictor of outcome, although a larger study is needed to verify this.

Clinical trial registration

NCT00424515

Available only for authorised users

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Title: Metabolic response by FDG-PET to imatinib correlates with exon 11 KIT mutation and predicts outcome in patients with mucosal melanoma
Authors: Katherine Zukotynski
Jeffrey T Yap
Anita Giobbie-Hurder
Jeffrey Weber
Rene Gonzalez
Thomas F Gajewski
Steven O’Day
Kevin Kim
F Stephen Hodi
Annick D Van den Abbeele
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Cancer Imaging / Issue 1/2014
Electronic ISSN: 1470-7330
DOI: https://doi.org/10.1186/s40644-014-0030-0

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