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Alpha-fetoprotein kinetics in patients with hepatocellular carcinoma receiving ramucirumab or placebo: An analysis of the phase 3 REACH study

 Ian Chau  ;  Joon Oh Park  ;  Baek-Yeol Ryoo  ;  Chia-Jui Yen  ;  Ronnie Poon  ;  Davide Pastorelli  ;  Jean-Frédéric Blanc  ;  Masatoshi Kudo  ;  Tulio Pfiffer  ;  Etsuro Hatano  ;  Hyun Cheol Chung  ;  Katerina Kopeckova  ;  Jean-Marc Phelip  ;  Giovanni Brandi  ;  Shinichi Ohkawa  ;  Chung-Pin Li  ;  Takuji Okusaka  ;  Yanzhi Hsu  ;  Paolo B. Abada  ;  Andrew X. Zhu 
 British Journal of Cancer, Vol.119(1) : 19-26, 2018 
Journal Title
 British Journal of Cancer 
Issue Date
BACKGROUND: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. METHODS: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. RESULTS: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4-34.6) compared to HER-2 negative (7.4, 1.6-39.1, P < 0.001). Among all patients, WB TLG > 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300-3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950-4.618; P < 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. CONCLUSIONS: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
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정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
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