Early response evaluation using 18F-FDG-PET/CT does not influence management of patients with metastatic gastrointestinal stromal tumors (GIST) treated with palliative intent

Sheima Farag, Nikki S IJzerman, Matthijs P M Houdijk, An K L Reyners, Anne Ij Arens, Dirk J Grünhagen, Ingrid M E Desar, Hans Gelderblom, Neeltje Steeghs, Lioe-Fee de Geus-Oei

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Abstract

AIM: The aim of this study was to investigate the impact of 18F-FDG-PET/CT on treatment decision making in metastatic gastrointestinal stromal tumor (GIST) patients.

METHODS: This study retrospectively evaluated 18F-FDG-PET/CT scans to monitor response of metastatic GIST patients treated with palliative intent. Data from the Dutch GIST Registry was used. Early scans (<10 weeks after start of treatment) and late scans (>10 weeks after start of treatment) were scored on the impact in change of treatment.

RESULTS: Sixty-one PET/CT scans were performed for treatment evaluation in 39 patients with metastatic GIST of which 36 were early scans and 25 were late scans. Early PET/CT scans led to a change in management in 5.6% of patients and late PET/CT scans led to a change in management in 56% of patients. Change in management was more often seen after scans with lack of metabolic response (48% vs. 11% in scans with metabolic response, p=0.002). Neither metabolic response nor change in treatment were more often seen in patients with KIT mutations compared to patients with non-KIT mutations (metabolic response 65% KIT vs. 46% non-KIT, p=0.33, and change in management 28% KIT vs. 21% non-KIT, p=0.74).

CONCLUSION: 18F-FDG-PET/CT is not recommended for early response evaluation in an unselected patient population with metastatic GIST, since it does not influence treatment decisions. 18F-FDG-PET/CT, however, can be useful for late response assessment, especially in case of indeterminate CT results.

Original languageEnglish
Pages (from-to)411-416
Number of pages6
JournalNuclear Medicine-Nuklearmedizin
Volume60
Issue number6
DOIs
Publication statusPublished - 3 Sept 2021

Bibliographical note

Funding:
A research grant for the Dutch GIST Registry was received from Deciphera (4EE9EEC-7F19-484D-86A4-646CFE0950A5), Novartis (3017/13),
Pfizer (WI189378) and Bayer (2013-MED-12005). These funding sources
did not have any involvement in the conduction of this research.

Thieme. All rights reserved.

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