Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial

Kazuto Harada; Xuemei Wang; Yusuke Shimodaira; Tara Sagebiel; Manoop S. Bhutani; Jeffrey H. Lee; Brian Weston; Elena Elimova; Quan Lin; Fatemeh G. Amlashi; Dilsa Mizrak Kaya; Anthony Lopez; Mariela A. Blum Murphy; Jack A. Roth; Stephen G. Swisher; Heath D. Skinner; Wayne L. Hofstetter; Jane E. Rogers; Irene Thomas; Dipen M. Maru; Ritsuko Komaki; Garrett Walsh; Jaffer A. Ajani

doi:10.1007/s11523-017-0540-3

Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial

Kazuto Harada, Xuemei Wang, Yusuke Shimodaira, Tara Sagebiel, Manoop S. Bhutani, Jeffrey H. Lee, Brian Weston, Elena Elimova, Quan Lin, Fatemeh G. Amlashi, Dilsa Mizrak Kaya, Anthony Lopez, Mariela A. Blum Murphy, Jack A. Roth, Stephen G. Swisher, Heath D. Skinner, Wayne L. Hofstetter, Jane E. Rogers, Irene Thomas, Dipen M. MaruRitsuko Komaki, Garrett Walsh, Jaffer A. Ajani

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12 Scopus citations

Abstract

Background: Early metabolic response after preoperative induction chemotherapy (IC) appears to predict histologic response and prognosis in esophageal cancer (EC), but the usefulness of this approach needs further development. Objective: We evaluated metabolic response after one cycle of IC using positron emission tomography (PET) to correlate PET response and outcomes. Patients and Methods: We retrospectively analyzed PET data from a randomized phase 2 trial (NCT00525915) of chemoradiation and surgery with or without IC for the treatment of EC. PET was performed at baseline, after one cycle of IC, and 5–7 weeks after chemoradiation. The relationship between PET response (≥35% reduction in standardized uptake value [SUV]) after IC and treatment response was analyzed. Results: In 63 patients who received IC, the mean initial SUV_max prior to treatment was 11.9 ± 8.04 and mean SUV_max after one cycle of IC was 6.47 ± 4.45. The mean SUV reduction after IC was 39.3%. Eleven of 37 PET responders achieved a pathologic complete response (pCR), but only two of 22 PET non-responders did (univariate logistic regression; odds ratio: 4.25, 95% confidence interval: 0.83–21.77; p = 0.08). PET responders to IC had significantly longer overall survival (OS) than PET nonresponders (log-rank p = 0.009). PET response after chemoradiation was not correlated with OS (log-rank p = 0.15). Conclusion: Early PET response after IC is prognostic, but subsequent PET changes (for example, after chemoradiation) are not prognostic. Early PET response might have the potential of predicting pCR.

Original language	English (US)
Pages (from-to)	99-106
Number of pages	8
Journal	Targeted oncology
Volume	13
Issue number	1
DOIs	https://doi.org/10.1007/s11523-017-0540-3
State	Published - Feb 1 2018

ASJC Scopus subject areas

Oncology
Cancer Research
Pharmacology (medical)

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Harada, K., Wang, X., Shimodaira, Y., Sagebiel, T., Bhutani, M. S., Lee, J. H., Weston, B., Elimova, E., Lin, Q., Amlashi, F. G., Mizrak Kaya, D., Lopez, A., Blum Murphy, M. A., Roth, J. A., Swisher, S. G., Skinner, H. D., Hofstetter, W. L., Rogers, J. E., Thomas, I., ... Ajani, J. A. (2018). Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial. Targeted oncology, 13(1), 99-106. https://doi.org/10.1007/s11523-017-0540-3

Harada, K, Wang, X, Shimodaira, Y, Sagebiel, T , Bhutani, MS , Lee, JH , Weston, B, Elimova, E, Lin, Q, Amlashi, FG, Mizrak Kaya, D, Lopez, A, Blum Murphy, MA, Roth, JA, Swisher, SG, Skinner, HD, Hofstetter, WL, Rogers, JE, Thomas, I, Maru, DM, Komaki, R, Walsh, G & Ajani, JA 2018, 'Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial', Targeted oncology, vol. 13, no. 1, pp. 99-106. https://doi.org/10.1007/s11523-017-0540-3

@article{f4cbea0e235640a395e511ea8c494e71,

title = "Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial",

abstract = "Background: Early metabolic response after preoperative induction chemotherapy (IC) appears to predict histologic response and prognosis in esophageal cancer (EC), but the usefulness of this approach needs further development. Objective: We evaluated metabolic response after one cycle of IC using positron emission tomography (PET) to correlate PET response and outcomes. Patients and Methods: We retrospectively analyzed PET data from a randomized phase 2 trial (NCT00525915) of chemoradiation and surgery with or without IC for the treatment of EC. PET was performed at baseline, after one cycle of IC, and 5–7 weeks after chemoradiation. The relationship between PET response (≥35% reduction in standardized uptake value [SUV]) after IC and treatment response was analyzed. Results: In 63 patients who received IC, the mean initial SUVmax prior to treatment was 11.9 ± 8.04 and mean SUVmax after one cycle of IC was 6.47 ± 4.45. The mean SUV reduction after IC was 39.3%. Eleven of 37 PET responders achieved a pathologic complete response (pCR), but only two of 22 PET non-responders did (univariate logistic regression; odds ratio: 4.25, 95% confidence interval: 0.83–21.77; p = 0.08). PET responders to IC had significantly longer overall survival (OS) than PET nonresponders (log-rank p = 0.009). PET response after chemoradiation was not correlated with OS (log-rank p = 0.15). Conclusion: Early PET response after IC is prognostic, but subsequent PET changes (for example, after chemoradiation) are not prognostic. Early PET response might have the potential of predicting pCR.",

author = "Kazuto Harada and Xuemei Wang and Yusuke Shimodaira and Tara Sagebiel and Bhutani, {Manoop S.} and Lee, {Jeffrey H.} and Brian Weston and Elena Elimova and Quan Lin and Amlashi, {Fatemeh G.} and {Mizrak Kaya}, Dilsa and Anthony Lopez and {Blum Murphy}, {Mariela A.} and Roth, {Jack A.} and Swisher, {Stephen G.} and Skinner, {Heath D.} and Hofstetter, {Wayne L.} and Rogers, {Jane E.} and Irene Thomas and Maru, {Dipen M.} and Ritsuko Komaki and Garrett Walsh and Ajani, {Jaffer A.}",

note = "Publisher Copyright: {\textcopyright} 2017, Springer International Publishing AG, part of Springer Nature.",

year = "2018",

month = feb,

day = "1",

doi = "10.1007/s11523-017-0540-3",

language = "English (US)",

volume = "13",

pages = "99--106",

journal = "Targeted oncology",

issn = "1776-2596",

publisher = "Springer Paris",

number = "1",

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TY - JOUR

T1 - Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer

T2 - Secondary Analysis of a Randomized Trial

AU - Harada, Kazuto

AU - Wang, Xuemei

AU - Shimodaira, Yusuke

AU - Sagebiel, Tara

AU - Bhutani, Manoop S.

AU - Lee, Jeffrey H.

AU - Weston, Brian

AU - Elimova, Elena

AU - Lin, Quan

AU - Amlashi, Fatemeh G.

AU - Mizrak Kaya, Dilsa

AU - Lopez, Anthony

AU - Blum Murphy, Mariela A.

AU - Roth, Jack A.

AU - Swisher, Stephen G.

AU - Skinner, Heath D.

AU - Hofstetter, Wayne L.

AU - Rogers, Jane E.

AU - Thomas, Irene

AU - Maru, Dipen M.

AU - Komaki, Ritsuko

AU - Walsh, Garrett

AU - Ajani, Jaffer A.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: Early metabolic response after preoperative induction chemotherapy (IC) appears to predict histologic response and prognosis in esophageal cancer (EC), but the usefulness of this approach needs further development. Objective: We evaluated metabolic response after one cycle of IC using positron emission tomography (PET) to correlate PET response and outcomes. Patients and Methods: We retrospectively analyzed PET data from a randomized phase 2 trial (NCT00525915) of chemoradiation and surgery with or without IC for the treatment of EC. PET was performed at baseline, after one cycle of IC, and 5–7 weeks after chemoradiation. The relationship between PET response (≥35% reduction in standardized uptake value [SUV]) after IC and treatment response was analyzed. Results: In 63 patients who received IC, the mean initial SUVmax prior to treatment was 11.9 ± 8.04 and mean SUVmax after one cycle of IC was 6.47 ± 4.45. The mean SUV reduction after IC was 39.3%. Eleven of 37 PET responders achieved a pathologic complete response (pCR), but only two of 22 PET non-responders did (univariate logistic regression; odds ratio: 4.25, 95% confidence interval: 0.83–21.77; p = 0.08). PET responders to IC had significantly longer overall survival (OS) than PET nonresponders (log-rank p = 0.009). PET response after chemoradiation was not correlated with OS (log-rank p = 0.15). Conclusion: Early PET response after IC is prognostic, but subsequent PET changes (for example, after chemoradiation) are not prognostic. Early PET response might have the potential of predicting pCR.

AB - Background: Early metabolic response after preoperative induction chemotherapy (IC) appears to predict histologic response and prognosis in esophageal cancer (EC), but the usefulness of this approach needs further development. Objective: We evaluated metabolic response after one cycle of IC using positron emission tomography (PET) to correlate PET response and outcomes. Patients and Methods: We retrospectively analyzed PET data from a randomized phase 2 trial (NCT00525915) of chemoradiation and surgery with or without IC for the treatment of EC. PET was performed at baseline, after one cycle of IC, and 5–7 weeks after chemoradiation. The relationship between PET response (≥35% reduction in standardized uptake value [SUV]) after IC and treatment response was analyzed. Results: In 63 patients who received IC, the mean initial SUVmax prior to treatment was 11.9 ± 8.04 and mean SUVmax after one cycle of IC was 6.47 ± 4.45. The mean SUV reduction after IC was 39.3%. Eleven of 37 PET responders achieved a pathologic complete response (pCR), but only two of 22 PET non-responders did (univariate logistic regression; odds ratio: 4.25, 95% confidence interval: 0.83–21.77; p = 0.08). PET responders to IC had significantly longer overall survival (OS) than PET nonresponders (log-rank p = 0.009). PET response after chemoradiation was not correlated with OS (log-rank p = 0.15). Conclusion: Early PET response after IC is prognostic, but subsequent PET changes (for example, after chemoradiation) are not prognostic. Early PET response might have the potential of predicting pCR.

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U2 - 10.1007/s11523-017-0540-3

DO - 10.1007/s11523-017-0540-3

M3 - Article

C2 - 29218623

AN - SCOPUS:85037376809

SN - 1776-2596

VL - 13

SP - 99

EP - 106

JO - Targeted oncology

JF - Targeted oncology

IS - 1

ER -

Early Metabolic Change after Induction Chemotherapy Predicts Histologic Response and Prognosis in Patients with Esophageal Cancer: Secondary Analysis of a Randomized Trial

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