18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors

Selumetinib (AZD6244, ARRY-142886) is a potent, selective, uncompetitive inhibitor of MEK 1 / 2, part of the RAF/MEK/ERK protein kinase signal cascade, which is responsible for tumor. This pilot study was used to explore if 18  F-fluoro-l-thymidine (FLT), a thymidine analogue positron emission tomog...

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Main Authors: Ingrid Desar, Rozemarie Gilles, Carla van Herpen, Anja J. Timmer-Bonte, Mireille Cantarini, Winette van der Graaf, Wim Oyen
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2012-04-01
Series:World Journal of Nuclear Medicine
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103413
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author Ingrid Desar
Rozemarie Gilles
Carla van Herpen
Anja J. Timmer-Bonte
Mireille Cantarini
Winette van der Graaf
Wim Oyen
author_facet Ingrid Desar
Rozemarie Gilles
Carla van Herpen
Anja J. Timmer-Bonte
Mireille Cantarini
Winette van der Graaf
Wim Oyen
author_sort Ingrid Desar
collection DOAJ
description Selumetinib (AZD6244, ARRY-142886) is a potent, selective, uncompetitive inhibitor of MEK 1 / 2, part of the RAF/MEK/ERK protein kinase signal cascade, which is responsible for tumor. This pilot study was used to explore if 18  F-fluoro-l-thymidine (FLT), a thymidine analogue positron emission tomography (PET) tracer and a surrogate marker for proliferation, can be used as an early predictor of response for patients with solid cancers treated with Selumetinib. FLT-PET scans were performed in four patients at baseline and after 2 weeks of treatment with Selumetinib. FLT uptake in tumors was analyzed qualitatively and quantitatively by measuring standard uptake value (SUV) max in regions of interest (ROI). Results were compared to computed tomography (CT) scans (baseline and after 8 weeks), which were evaluated using the response evaluation criteria in solid tumors (RECIST) 1.0 criteria. One patient with melanoma showed both a qualitative and quantitative decrease in FLT uptake associated with a decrease in sum of longest diameter of 12% RECIST on CT evaluation. Another patient who had colorectal carcinoma (CRC) showed a significant increase in FLT uptake with initially stable, but eventually progressive disease on CT. The other two patients (one with melanoma and one with CRC) showed no significant changes in FLT uptake, whereas CT evaluation showed progressive disease. This is the first report describing changes in FLT-PET in patients receiving Selumetinib. In two patients, changes in FLT uptake as early as after 2 weeks of treatment were consistent with CT results after 8 weeks. Biomarkers to predict and evaluate treatment the outcome of targeted therapies are highly warranted. These initial results need further investigation.
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spelling doaj-art-9eac28347b10495695e792bcaf8d7d6b2025-08-20T02:54:43ZengThieme Medical and Scientific Publishers Pvt. Ltd.World Journal of Nuclear Medicine1450-11471607-33122012-04-011102656910.4103/1450-1147.10341318 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumorsIngrid Desar0Rozemarie Gilles1Carla van Herpen2Anja J. Timmer-Bonte3Mireille Cantarini4Winette van der Graaf5Wim Oyen6Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsDepartment of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsDepartment of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsDepartment of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsAstra Zeneca, Alderley Park, Macclesfield, UKDepartment of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsDepartment of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsSelumetinib (AZD6244, ARRY-142886) is a potent, selective, uncompetitive inhibitor of MEK 1 / 2, part of the RAF/MEK/ERK protein kinase signal cascade, which is responsible for tumor. This pilot study was used to explore if 18  F-fluoro-l-thymidine (FLT), a thymidine analogue positron emission tomography (PET) tracer and a surrogate marker for proliferation, can be used as an early predictor of response for patients with solid cancers treated with Selumetinib. FLT-PET scans were performed in four patients at baseline and after 2 weeks of treatment with Selumetinib. FLT uptake in tumors was analyzed qualitatively and quantitatively by measuring standard uptake value (SUV) max in regions of interest (ROI). Results were compared to computed tomography (CT) scans (baseline and after 8 weeks), which were evaluated using the response evaluation criteria in solid tumors (RECIST) 1.0 criteria. One patient with melanoma showed both a qualitative and quantitative decrease in FLT uptake associated with a decrease in sum of longest diameter of 12% RECIST on CT evaluation. Another patient who had colorectal carcinoma (CRC) showed a significant increase in FLT uptake with initially stable, but eventually progressive disease on CT. The other two patients (one with melanoma and one with CRC) showed no significant changes in FLT uptake, whereas CT evaluation showed progressive disease. This is the first report describing changes in FLT-PET in patients receiving Selumetinib. In two patients, changes in FLT uptake as early as after 2 weeks of treatment were consistent with CT results after 8 weeks. Biomarkers to predict and evaluate treatment the outcome of targeted therapies are highly warranted. These initial results need further investigation.http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103413f-18 fltpet-ctselumetinibtreatment response
spellingShingle Ingrid Desar
Rozemarie Gilles
Carla van Herpen
Anja J. Timmer-Bonte
Mireille Cantarini
Winette van der Graaf
Wim Oyen
18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
World Journal of Nuclear Medicine
f-18 flt
pet-ct
selumetinib
treatment response
title 18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
title_full 18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
title_fullStr 18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
title_full_unstemmed 18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
title_short 18 F-FLT-PET for response evaluation of MEK inhibitor selumetinib (AZD6244, ARRY-142886) in patients with solid tumors
title_sort 18 f flt pet for response evaluation of mek inhibitor selumetinib azd6244 arry 142886 in patients with solid tumors
topic f-18 flt
pet-ct
selumetinib
treatment response
url http://www.thieme-connect.de/DOI/DOI?10.4103/1450-1147.103413
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