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Prognostic Significance of ^99mTc Hynic-rh-Annexin V Scintigraphy During Platinum-Based Chemotherapy in Advanced Lung Cancer

Marina Kartachova, Nico van Zandwijk, Sjaak Burgers, Harm van Tinteren, Marcel Verheij, Renato Alfredo Valdés Olmos

From the Departments of Nuclear Medicine, Radiotherapy, Thoracic Oncology, and Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands

Address reprint requests to Renato Alfredo Valdés Olmos, MD, Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands; e-mail: r.valdes{at}nki.nl

Purpose The purpose of this study was to evaluate if sequential ^99mTc Hynic-rh- annexin V scintigraphy (TAS) can predict outcome in patients with advanced lung cancer, shortly after the start of platinum-based chemotherapy.

Patients and Methods In 16 consecutive chemotherapy-naive patients with advanced stage non–small-cell lung cancer scheduled for platinum-based chemotherapy, TAS was performed before and within 48 hours after the start of therapy. Chemotherapy-induced changes in tumor annexin V uptake, calculated as maximum count per pixel and expressed as percentage to baseline value, were compared with treatment response determined according to Response Evaluation Criteria in Solid Tumors.

Results A significant correlation (r² = 0.86; P = .0001) was found between annexin V metabolic changes and treatment outcome. All patients with notably increased annexin V tumor uptake showed complete or partial response. Less prominently increased or decreased uptake correlated with stable or progressive disease.

Conclusion TAS is a promising test to predict tumor response in patients with advanced lung cancer early in the course of platinum-based chemotherapy.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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