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J Nucl Med. 2012 Apr;53(4):530-7. doi: 10.2967/jnumed.111.092544. Epub 2012 Mar 13.

18F-FDG PET as a surrogate biomarker in non-small cell lung cancer treated with erlotinib: newly identified lesions are more informative than standardized uptake value.

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  • 1Biostatistics, Genentech Inc., South San Francisco, CA, USA. thomasgb@gene.com


This study assesses the predictive value of (18)F-FDG PET for overall survival in lung cancer patients treated with a targeted drug.


(18)F-FDG PET was performed in 125 second- or third-line non-small cell lung cancer (NSCLC) patients with a baseline Eastern Cooperative Oncology Group performance status less than 3 before treatment with erlotinib (150 mg daily) and 2 wk into treatment. The predictive value of (18)F-FDG PET, clinical parameters, and epithelial growth factor receptor (EGFR) mutation status for survival duration was evaluated by fitting accelerated failure time models.


New lesions on PET at 2 wk, EGFR mutation status, performance status, and baseline tumor burden were independent and significant predictors of overall survival. Reduction of maximum standardized uptake value by at least 35% was predictive of survival only when EGFR mutation status was not accounted for.


(18)F-FDG PET in second- or third-line NSCLC patients at 2 wk after starting treatment with erlotinib carries information about overall survival. Parametric survival modeling enables a quantitative assessment of the predictive value of (18)F-FDG PET in the context of clinical and laboratory information. New-lesion status by (18)F-FDG PET at 2 wk is a potential surrogate biomarker for survival in NSCLC.

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