The Role of F-18 FLT PET/CT for Selecting the Patients Who Need Maintenance Treatment After First-line Chemotherapy in Advanced Non-small Cell Lung Cancers
Standard therapy for patients with advanced NSCLC is platinum based doublet chemotherapy.
Current first-line chemotherapy is usually limited to 4-6 cycles, as prolonging treatment
does not result in additional benefit and may often cause further toxicity. Until recently,
treatment guidelines recommended withholding administration of later-line systemic
anti-cancer treatment until disease progression.
There are several reports suggesting that maintenance therapy following first-line
chemotherapy offers improved survival in advance stage patients. This approach involves the
administration of an active treatment immediately after first-line chemotherapy, thus
maintaining the clinical benefit initially obtained. However, drug related toxicity and
costs are of great concern. There may also be patients with less aggressive disease where an
immediate transition to maintenance therapy after first-line results in overtreatment.
Therefore, selecting patients who require more aggressive treatment or earlier intervention
If FLT PET/CT can discriminate the patients with shorter progression free survival and
overall survival in this pilot study, patients could be selected for more aggressive or
earlier treatment such as maintenance therapy, and the investigators could expect to prolong
survival while reducing the adverse events and costs that will accompany inconsequential
therapy with FLT PET/CT.
Observational Model: Case-Only, Time Perspective: Prospective
from the date of FLT PET/CT to the date of death or last follow-up, assessed up to 1 year
Ie Ryung Yoo, MD
Seoul St. Mary's Hospital
Korea: Institutional Review Board