PET/CT-tailored treatment of locally advanced oesophago-gastric
junction adenocarcinoma: a report on the feasibility of the
multicenter GastroPET study

J 2021

PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study

OBERMANNOVÁ, Radka, Iveta SELINGEROVÁ, Zdeněk ŘEHÁK, Václav JEDLIČKA, Marek SLÁVIK et. al.

Basic information

Original name

PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study

Authors

OBERMANNOVÁ, Radka (203 Czech Republic, guarantor, belonging to the institution), Iveta SELINGEROVÁ (203 Czech Republic, belonging to the institution), Zdeněk ŘEHÁK (203 Czech Republic), Václav JEDLIČKA (203 Czech Republic, belonging to the institution), Marek SLÁVIK (703 Slovakia), Pavel FABIAN (203 Czech Republic), Ivo NOVOTNÝ (203 Czech Republic), Milada ZEMANOVA (203 Czech Republic), Hana STUDENTOVA (203 Czech Republic), Peter GRELL (703 Slovakia, belonging to the institution), Lenka ZDRAŽILOVÁ DUBSKÁ (203 Czech Republic), Regina DEMLOVÁ (203 Czech Republic, belonging to the institution), Tomáš HARUSTIAK, Renata HEJNOVA (203 Czech Republic), Igor KISS (203 Czech Republic, belonging to the institution) and Rostislav VYZULA (203 Czech Republic, belonging to the institution)

Edition

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY, LONDON, SAGE PUBLICATIONS LTD, 2021, 1758-8340

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

GastroPET

Impact factor

Impact factor: 5.485

RIV identification code

RIV/00216224:14110/21:00120205

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1177/17588359211065153

UT WoS

000730612700001

Keywords (in Czech)

localised oesophago-gastric junction adenocarcinoma; metabolic imaging; non-responders; PET; CT-guided preoperative treatment strategy

Keywords in English

localised oesophago-gastric junction adenocarcinoma; metabolic imaging; non-responders; PET; CT-guided preoperative treatment strategy

Abstract

V originále

Background: Perioperative chemotherapy is a recommended treatment approach for localised oesophago-gastric junction adenocarcinoma, but not all patients respond to neoadjuvant chemotherapy. Early identification of non-responders and treatment adaptation in the preoperative period could improve outcomes. GastroPET is a national, multicentre phase II trial evaluating a (18)FDG-PET/CT-guided preoperative treatment strategy with the R0 resection rate as a primary endpoint. Here, we report on the accuracy of the methodology, the feasibility of the study design and patient safety data after enrolment of the first 63 patients. Methods: Patients with locally advanced oesophago-gastric junction adenocarcinoma (Siewert I - III) stage Ib-IIIc underwent baseline 18FDG-PET/CT scanning and re-evaluation after 14 days of oxaliplatinum-5FU-(docetaxel) chemotherapy. Responders were defined by a > 35% decrease in tumour FDG standardised uptake value (SUV)(average) from baseline. Responders continued with the same chemotherapy for 2 to 3 months prior to surgery. PET-non-responders switched to preoperative chemoradiotherapy [weekly carboplatin and paclitaxel with concurrent radiotherapy (45 Gy in 25 fractions)]. Here, we aim to confirm the feasibility of FDG-PET-based response assessment in a multicenter setting and to compare local versus central reading. In addition, we report on the feasibility of the study conduct and patient safety data. Results: A total of 64 patients received baseline and sequential 14-day 18FDG-PET/CT scanning. And, 63 were allocated to the respective treatment arm according to PET-response [35 (56%) responders and 28 (44%) non-responders]. The concordance of local versus central reading of SUV changes was 100%. Until the date of this analysis, 47 patients (28 responders and 19 non-responders) completed surgery. Postoperative complications of grade > 3 (Common Terminology Criteria for Adverse Events, CTCAE Version 5.0) were reported in five responders (18%; 95% CI: 7.9-36%) and two non-responders (11%; 95% CI: 2.9-31%), with no statistical difference (p = 0.685). One patient in each arm died after surgery, leading to a postoperative in-hospital mortality rate of 4.3% (2/47 patients; 95% CI: 1.2-14%). Conclusion: Local and central FDG-SUV quantification and PET-response assessment showed high concordance. This confirms the accuracy of a PET-response-guided treatment algorithm for locally advanced oesophago-gastric junction cancer in a multicenter setting. Preoperative treatment adaptation revealed feasible and safe for patients.

Links

NV17-29389A, research and development project

Name: Sekvenční FDG-PET a miRNA jako biomarker změny strategie předoperační léčby u lokálně pokročilého karcinomu žaludku a gastroesofageální junkce

90125, large research infrastructures

Name: BBMRI-CZ III

90128, large research infrastructures

Name: CZECRIN III

Citovat

OBERMANNOVÁ, Radka, Iveta SELINGEROVÁ, Zdeněk ŘEHÁK, Václav JEDLIČKA, Marek SLÁVIK, Pavel FABIAN, Ivo NOVOTNÝ, Milada ZEMANOVA, Hana STUDENTOVA, Peter GRELL, Lenka ZDRAŽILOVÁ DUBSKÁ, Regina DEMLOVÁ, Tomáš HARUSTIAK, Renata HEJNOVA, Igor KISS and Rostislav VYZULA. PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study. THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY. LONDON: SAGE PUBLICATIONS LTD, 2021, vol. 13, December 2021, p. 1-14. ISSN 1758-8340. Available from: https://dx.doi.org/10.1177/17588359211065153.

@article{1818744,
   author = {Obermannová, Radka and Selingerová, Iveta and Řehák, Zdeněk and Jedlička, Václav and Slávik, Marek and Fabian, Pavel and Novotný, Ivo and Zemanova, Milada and Studentova, Hana and Grell, Peter and Zdražilová Dubská, Lenka and Demlová, Regina and Harustiak, Tomáš and Hejnova, Renata and Kiss, Igor and Vyzula, Rostislav},
   article_location = {LONDON},
   article_number = {December 2021},
   doi = {http://dx.doi.org/10.1177/17588359211065153},
   keywords = {localised oesophago-gastric junction adenocarcinoma; metabolic imaging; non-responders; PET; CT-guided preoperative treatment strategy},
   language = {eng},
   issn = {1758-8340},
   journal = {THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY},
   note = {GastroPET},
   title = {PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study},
   url = {https://journals.sagepub.com/doi/10.1177/17588359211065153},
   volume = {13},
   year = {2021}
}

TY  - JOUR
ID  - 1818744
AU  - Obermannová, Radka - Selingerová, Iveta - Řehák, Zdeněk - Jedlička, Václav - Slávik, Marek - Fabian, Pavel - Novotný, Ivo - Zemanova, Milada - Studentova, Hana - Grell, Peter - Zdražilová Dubská, Lenka - Demlová, Regina - Harustiak, Tomáš - Hejnova, Renata - Kiss, Igor - Vyzula, Rostislav
PY  - 2021
TI  - PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study
JF  - THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY
VL  - 13
IS  - December 2021
SP  - 1-14
EP  - 1-14
PB  - SAGE PUBLICATIONS LTD
SN  - 17588340
N1  - GastroPET
KW  - localised oesophago-gastric junction adenocarcinoma
KW  - metabolic imaging
KW  - non-responders
KW  - PET
KW  - CT-guided preoperative treatment strategy
UR  - https://journals.sagepub.com/doi/10.1177/17588359211065153
N2  - Background: Perioperative chemotherapy is a recommended treatment approach for localised oesophago-gastric junction adenocarcinoma, but not all patients respond to neoadjuvant chemotherapy. Early identification of non-responders and treatment adaptation in the preoperative period could improve outcomes. GastroPET is a national, multicentre phase II trial evaluating a (18)FDG-PET/CT-guided preoperative treatment strategy with the R0 resection rate as a primary endpoint. Here, we report on the accuracy of the methodology, the feasibility of the study design and patient safety data after enrolment of the first 63 patients. Methods: Patients with locally advanced oesophago-gastric junction adenocarcinoma (Siewert I - III) stage Ib-IIIc underwent baseline 18FDG-PET/CT scanning and re-evaluation after 14 days of oxaliplatinum-5FU-(docetaxel) chemotherapy. Responders were defined by a > 35% decrease in tumour FDG standardised uptake value (SUV)(average) from baseline. Responders continued with the same chemotherapy for 2 to 3 months prior to surgery. PET-non-responders switched to preoperative chemoradiotherapy [weekly carboplatin and paclitaxel with concurrent radiotherapy (45 Gy in 25 fractions)]. Here, we aim to confirm the feasibility of FDG-PET-based response assessment in a multicenter setting and to compare local versus central reading. In addition, we report on the feasibility of the study conduct and patient safety data. Results: A total of 64 patients received baseline and sequential 14-day 18FDG-PET/CT scanning. And, 63 were allocated to the respective treatment arm according to PET-response [35 (56%) responders and 28 (44%) non-responders]. The concordance of local versus central reading of SUV changes was 100%. Until the date of this analysis, 47 patients (28 responders and 19 non-responders) completed surgery. Postoperative complications of grade > 3 (Common Terminology Criteria for Adverse Events, CTCAE Version 5.0) were reported in five responders (18%; 95% CI: 7.9-36%) and two non-responders (11%; 95% CI: 2.9-31%), with no statistical difference (p = 0.685). One patient in each arm died after surgery, leading to a postoperative in-hospital mortality rate of 4.3% (2/47 patients; 95% CI: 1.2-14%). Conclusion: Local and central FDG-SUV quantification and PET-response assessment showed high concordance. This confirms the accuracy of a PET-response-guided treatment algorithm for locally advanced oesophago-gastric junction cancer in a multicenter setting. Preoperative treatment adaptation revealed feasible and safe for patients.
ER  -

OBERMANNOVÁ, Radka, Iveta SELINGEROVÁ, Zdeněk ŘEHÁK, Václav JEDLIČKA, Marek SLÁVIK, Pavel FABIAN, Ivo NOVOTNÝ, Milada ZEMANOVA, Hana STUDENTOVA, Peter GRELL, Lenka ZDRAŽILOVÁ DUBSKÁ, Regina DEMLOVÁ, Tomáš HARUSTIAK, Renata HEJNOVA, Igor KISS and Rostislav VYZULA. PET/CT-tailored treatment of locally advanced oesophago-gastric junction adenocarcinoma: a report on the feasibility of the multicenter GastroPET study. \textit{THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY}. LONDON: SAGE PUBLICATIONS LTD, 2021, vol.~13, December 2021, p.~1-14. ISSN~1758-8340. Available from: https://dx.doi.org/10.1177/17588359211065153.

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