Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study
BACKGROUND: Lenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes....
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352209/ https://www.ncbi.nlm.nih.gov/pubmed/37460834 http://dx.doi.org/10.1186/s13550-023-01019-9 |
_version_ | 1785074464336117760 |
---|---|
author | Takeuchi, Satoshi Hirata, Kenji Magota, Keiichi Watanabe, Shiro Moku, Rika Shiiya, Akihiko Taguchi, Jun Ariga, Shin Goda, Tomohiro Ohhara, Yoshihito Noguchi, Takurou Shimizu, Yasushi Kinoshita, Ichiro Honma, Rio Tsuji, Yasushi Homma, Akihiro Dosaka-Akita, Hirotoshi |
author_facet | Takeuchi, Satoshi Hirata, Kenji Magota, Keiichi Watanabe, Shiro Moku, Rika Shiiya, Akihiko Taguchi, Jun Ariga, Shin Goda, Tomohiro Ohhara, Yoshihito Noguchi, Takurou Shimizu, Yasushi Kinoshita, Ichiro Honma, Rio Tsuji, Yasushi Homma, Akihiro Dosaka-Akita, Hirotoshi |
author_sort | Takeuchi, Satoshi |
collection | PubMed |
description | BACKGROUND: Lenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes. RESULTS: This was a prospective, nonrandomised, multicentre study. Patients with pathologically confirmed differentiated thyroid carcinoma (DTC) and lesions refractory to radioiodine treatment were eligible for inclusion. Patients were treated with 24 mg lenvatinib as the initial dose and underwent PET/CT examination 1 week after treatment initiation. Contrast-enhanced CT was scheduled at least 4 weeks later as the gold standard for evaluation. The primary endpoint was to evaluate the discrimination power of maximum standardised uptake value (SUVmax) obtained by PET/CT compared to that obtained by contrast-enhanced CT. Evaluation was performed using the area under the receiver operating characteristic (ROC-AUC) curve. Twenty-one patients were included in this analysis. Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.714 for SUVmax after 1 week of lenvatinib treatment. The best cut-off value for the treatment response for SUVmax was 15.211. The sensitivity and specificity of this cut-off value were 0.583 and 0.857, respectively. The median progression-free survival was 26.3 months in patients with an under-cut-off value and 19.7 months in patients with an over-cut-off value (P = 0.078). CONCLUSIONS: The therapeutic effects of lenvatinib were detected earlier than those of CT because of decreased FDG uptake on PET/CT. PET/CT examination 1 week after the initiation of lenvatinib treatment may predict treatment outcomes in patients with DTC. Trial registration: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (number UMIN000022592) on 6 June, 2016. |
format | Online Article Text |
id | pubmed-10352209 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-103522092023-07-19 Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study Takeuchi, Satoshi Hirata, Kenji Magota, Keiichi Watanabe, Shiro Moku, Rika Shiiya, Akihiko Taguchi, Jun Ariga, Shin Goda, Tomohiro Ohhara, Yoshihito Noguchi, Takurou Shimizu, Yasushi Kinoshita, Ichiro Honma, Rio Tsuji, Yasushi Homma, Akihiro Dosaka-Akita, Hirotoshi EJNMMI Res Original Research BACKGROUND: Lenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes. RESULTS: This was a prospective, nonrandomised, multicentre study. Patients with pathologically confirmed differentiated thyroid carcinoma (DTC) and lesions refractory to radioiodine treatment were eligible for inclusion. Patients were treated with 24 mg lenvatinib as the initial dose and underwent PET/CT examination 1 week after treatment initiation. Contrast-enhanced CT was scheduled at least 4 weeks later as the gold standard for evaluation. The primary endpoint was to evaluate the discrimination power of maximum standardised uptake value (SUVmax) obtained by PET/CT compared to that obtained by contrast-enhanced CT. Evaluation was performed using the area under the receiver operating characteristic (ROC-AUC) curve. Twenty-one patients were included in this analysis. Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.714 for SUVmax after 1 week of lenvatinib treatment. The best cut-off value for the treatment response for SUVmax was 15.211. The sensitivity and specificity of this cut-off value were 0.583 and 0.857, respectively. The median progression-free survival was 26.3 months in patients with an under-cut-off value and 19.7 months in patients with an over-cut-off value (P = 0.078). CONCLUSIONS: The therapeutic effects of lenvatinib were detected earlier than those of CT because of decreased FDG uptake on PET/CT. PET/CT examination 1 week after the initiation of lenvatinib treatment may predict treatment outcomes in patients with DTC. Trial registration: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (number UMIN000022592) on 6 June, 2016. Springer Berlin Heidelberg 2023-07-17 /pmc/articles/PMC10352209/ /pubmed/37460834 http://dx.doi.org/10.1186/s13550-023-01019-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Research Takeuchi, Satoshi Hirata, Kenji Magota, Keiichi Watanabe, Shiro Moku, Rika Shiiya, Akihiko Taguchi, Jun Ariga, Shin Goda, Tomohiro Ohhara, Yoshihito Noguchi, Takurou Shimizu, Yasushi Kinoshita, Ichiro Honma, Rio Tsuji, Yasushi Homma, Akihiro Dosaka-Akita, Hirotoshi Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title | Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title_full | Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title_fullStr | Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title_full_unstemmed | Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title_short | Early prediction of treatment outcome for lenvatinib using (18)F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
title_sort | early prediction of treatment outcome for lenvatinib using (18)f-fdg pet/ct in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10352209/ https://www.ncbi.nlm.nih.gov/pubmed/37460834 http://dx.doi.org/10.1186/s13550-023-01019-9 |
work_keys_str_mv | AT takeuchisatoshi earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT hiratakenji earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT magotakeiichi earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT watanabeshiro earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT mokurika earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT shiiyaakihiko earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT taguchijun earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT arigashin earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT godatomohiro earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT ohharayoshihito earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT noguchitakurou earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT shimizuyasushi earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT kinoshitaichiro earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT honmario earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT tsujiyasushi earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT hommaakihiro earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy AT dosakaakitahirotoshi earlypredictionoftreatmentoutcomeforlenvatinibusing18ffdgpetctinpatientswithunresectableoradvancedthyroidcarcinomarefractorytoradioiodinetreatmentaprospectivemulticentrenonrandomisedstudy |