Study On The Expression Of SEGFR By 11C-PD153035 PET/CT In Patients With Non-small Cell Lung Cancer

Objective: The expression of EGFR in peripheral blood(sEGFR) and the ¹¹C- 4-(3-bromoanilino)-6,7-dimethoxyquinazoline(¹¹C-PD153035) positron emission tomography/computed tomography(PET/CT) uptake values in primary foci before and after radiotherapy in patients with non-small cell lung cancer (NSCLC) were compared to investigate the correlation.Methods: From July 2009 to March 2010 ,15 Patients (11 men,4 women; age range, 48-78years, including 9 cases of squamous cell carcinoma, 1 case of large cell carcinoma, and the other of adenocarcinoma.)with pathologically proved advanced NSCLC were enrolled. ¹¹C-PD153035 PET/CT scanning was performed before and 2 weeks after received conformal radiation therapy and peripheral blood were collected simultaneously. ¹¹C-PD153035 uptake of primary tumors represented by SUV_max was measured.The level of EGFR in peripheral blood was also analyzed by ELISA. The changes between before and after radiotherapy were calculated.The Pearson correlation analysis was used to test the correlations between parameters of the two measurement methods. All patients received conformal radiation therapy combined with platinum-based chemotherapy.Results: All patients (¹¹ men,4 women; age range, 48-78years) have been enrolled in this study, including 9 cases of squamous cell carcinoma, 1 case of large cell carcinoma, and the other of adenocarcinoma. Tumor uptake of ¹¹C-PD153035 before received therapy was observed in 15 patients and _maximum standard uptake value(SUV_max) ranged from 1.25 to 6.1 and the sEGFR Cb ranged from 1.29μg/l to3.978μg/l. After radiotherapy, 10/15 patients underwent the second ¹¹C-PD153035 PET/ CT scanning and remaining 5 patients only received CT scanning. The SUV_max of the primary tumor after therapy ranged from 0.5 to 5.9 and the sEGFR Cb ranged from 0.88μg/l to 2.92μg /l. There was no significant difference between pre-and post-therapy in SUV_max and the Cb of EGFR (P>0.05). However there was a correlation of the expression of EGFR protein between sEGGR and SUV_max of primary tumors both before and after therapy(p<0.05).Conclusions: There is good correlation between the EGFR expression in peripheral blood and ¹¹C-PD153035 PET/CT uptake values of primary tumor before and after radiotherapy in patients with advanced NSCLC.Part 2 The pilot study of relationship between ¹¹C-PD153035 PET/CT imaging and chemoradiotherapy on local advanced NSCLCObjective: To investigate the difference of epidermal growth factor receptor ( EGFR ) expression level of tumor tissue in non-small cell lung cancer (NSCLC)with ¹¹C-PD153035 PET/CT imaging before and after chemoradiotherapy ,and to evaluate the relationship between EGFR level and short-term efficacy of concurrent chemoradiotherapy in advanced NSCLC .Methods: From July 2009 to March 2010 ,15 Patients(11 men,4 women; age range, 48-78years, including 9 cases of squamous cell carcinoma, 1 case of large cell carcinoma, and the remaining of adenocarcinoma.) with pathologically proved advanced NSCLC were enrolled. ¹¹C-PD153035 PET/CT scanning was performed before (PET/CT 1) and 4 weeks after (PET/CT 2) received concurrent chemoradiotherapy. PD153035 uptake of primary tumors represented by SUV_max was measured.All patients received conformal radiation therapy combined with platinum-based chemotherapy.The relationship between changes of the SUV_max and the therapy response was studied in the responsive and non-responsive groups after therapy .Independent t- test was used for statistical analysis .To further evaluate the predictive performance of SUV_max time-dependent receiver operating characteristic curve (ROC) analysis was used .Treatment response was also expressed by enhanced CT results 4 weeks after therapy on the basis of traditional Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results: Primary fociTumor uptake of ¹¹C-PD153035 before received therapy was observed in 15 patients with 15 foci and SUV_max ranged from 1.25 to 6.1. After radiotherapy, 10/15 patients with 10 foci underwent the second ¹¹C-PD153035 PET/CT scanning and all the 15 patients received enhanced CT scanning. The responders had a lower baseline of pre-therapy SUV_max than the nonresponders (t=-2.98,p<0.05). However, there was no significant difference between pre-and post-therapy SUV_max (t=-1.19,P>0.05)and the changes of SUV_max between the responders and non-responders(t=-0.007,P>0.05). Using the SUV_max before therapy of 2.66 yielded 66.67%(4/6)sensitivity,100%(9/9)specificity,100%(4/4) positive predictive value and 81.8%(9/¹¹) negative predictive value in predicting therapy response.Conclusions: Our data indicated that ¹¹C-PD153035 PET/CT before radiotherapy may have certain potientials value to predict response to chemoradiotherapy in patients of NSCLC. By which patients resistant to chemradiotherapy or not may be differentiated and more effective therapy may be taken to improve the effects of therapy.