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Long term follow-up of neoadjuvant chemotherapy for non-small cell lung cancer (NSCLC) investigating early positron emission tomography (PET) scan as a predictor of outcome

BMC Cancer Jan 20, 2019

Romine PE, et al. - Whether FDG (fluorodeoxyglucose) positron emission tomography (PET) scans in operable non-small cell lung cancer (NSCLC) patients may offer early prognostic or predictive value after one cycle of induction chemotherapy was investigated in this phase 2 non-randomized trial including patients with AJCC version 6 stage IB to IIIB operable NSCLC who were treated with 3 cycles of cisplatin and pemetrexed neoadjuvant chemotherapy. FDG-PET scans were performed prior to and 18 to 21 days after the first cycle of chemotherapy. Of 25 patients enrolled, 52% were female, 88% white, and median age was 62 years. Good tolerability of the treatment was evident, with grade 4 toxicity reported in only one patient. For overall population, the 5-year progression free survival (PFS) and overall survival (OS) were 54% and 67%, respectively. A baseline FDG-PET scan and a repeat scan at day 18–21 was available in 18 patients. On the day 18–21 FDG-PET scan, 10 patients (56%) were considered metabolic responders. In responders vs non-responders, 5-year PFS and OS were 60% and 70% vs 63% and 75%, respectively. In patients with NSCLC treated with neoadjuvant chemotherapy, a PET scan after one cycle of chemotherapy was not shown to be predictive of survival outcomes.

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