Data from the ACRIN 6668 Trial NSCLC-FDG-PET

Positron Emission Tomography Pre- and Post-treatment Assessment for Locally Advanced Non-small Cell Lung Carcinoma This was a multicenter clinical trial by the ACRIN Cooperative Group (now part of ECOG-ACRIN) and the RTOG Cooperative Group (now part of NRG) using FDG-PET imaging both pre- and post-chemoradiotherapy.The objective of the ACRIN 6668 multi-center clinical trial was to determine if the PET standardized uptake value (SUV) measurement from FDG-PET imaging shortly after treatment is a useful predictor of long-term clinical outcome (survival) after definitive chemoradiotherapy. Eligible patients were those older than 18 years with AJCC-criteria clinical stage IIB/III non-small cell lung carcinoma who were being planned for definitive concurrent chemoradiotherapy (inoperable disease).Primary Aim Findings: Higher post-treatment tumor SUV (SUVpeak, SUVmax) is associated with worse survival in stage III NSCLC, although a clear SUV cutoff value for routine clinical use as a prognostic factor was uncertain [1]. Later analyses found that larger pre-treatment metabolic tumor volumes (MTVs) were associated with significantly worse overall survival [2]. Other secondary analyses found potentially predictive image texture biomarkers.Study Design Summary: Patients received conventional concurrent platinum-based chemoradiotherapy without surgery; post-radiotherapy consolidation chemotherapy was allowed. A baseline whole-body FDG-PET scan was performed prior to therapy. A second post-treatment whole-body FDG-PET scan occurred approximately 14 weeks after radiotherapy (at least 4 weeks after adjuvant chemotherapy). Pre-treatment FDG-PET scans were performed on ACRIN-qualified scanners. Post-treatment FDG-PET scans were required to be performed within 12–16 weeks after completion of therapy, using the same scanner as that used for the pre-treatment scans.