Serial 18F-choline-PET imaging in patients receiving enzalutamide for metastatic castration-resistant prostate cancer: response assessment and imaging biomarkers

Future Oncol. 2016 Feb;12(3):333-42. doi: 10.2217/fon.15.277. Epub 2016 Jan 15.

Abstract

Aim: High rate of non-target lesions in metastatic castration-resistant prostate cancer usually limits applicability of Response Evaluation Criteria in Solid Tumors (RECIST) criteria, and this has led to a growing interest in using PET/computed tomography (CT). We prospectively investigated the role of (18)F-choline (FCH)-PET/CT in patients receiving enzalutamide after docetaxel.

Patients & methods: 30 patients were monitored by means of FCH-PET/CT before and during the treatment. A Cox proportional hazards regression model was used to assess the associations between metabolic parameters and clinical outcomes.

Results: Univariate analysis showed no significant correlation between biochemical and FCH-PET responses. Multivariate analysis showed that only baseline maximum standardized uptake value (SUVmax) significantly correlated with biochemical progression-free survival, radiological progression-free survival and overall survival.

Conclusion: Our findings suggest that FCH-PET/CT may play a role in defining prognosis of patients receiving enzalutamide because baseline SUVmax proved to be an independent prognostic factor.

Keywords: 18F-choline PET; castration-resistant prostate cancer; enzalutamide; response.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Biomarkers, Tumor / metabolism
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / mortality
  • Bone Neoplasms / secondary
  • Choline / analogs & derivatives
  • Choline / pharmacokinetics
  • Disease-Free Survival
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nitriles
  • Phenylthiohydantoin / analogs & derivatives*
  • Phenylthiohydantoin / therapeutic use
  • Positron-Emission Tomography
  • Proportional Hazards Models
  • Prostatic Neoplasms, Castration-Resistant / diagnostic imaging*
  • Prostatic Neoplasms, Castration-Resistant / drug therapy
  • Prostatic Neoplasms, Castration-Resistant / mortality
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Radiopharmaceuticals / pharmacokinetics
  • Tissue Distribution
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Benzamides
  • Biomarkers, Tumor
  • Nitriles
  • Radiopharmaceuticals
  • fluoromethylcholine
  • Phenylthiohydantoin
  • enzalutamide
  • Choline