Development of [11C]erlotinib Positron Emission Tomography for In Vivo Evaluation of EGF Receptor Mutational Status

• Published in: Clinical cancer research Vol. 19; no. 1; pp. 183 - 193
• Main Authors: BAHCE, Idris, SMIT, Egbert F, LAMMERTSMA, Adriaan A, HARRY HENDRIKSE, N, LUBBERINK, Mark, VAN DER VELDT, Astrid A. M, YAQUB, Maqsood, WINDHORST, Albert D, SCHUIT, Robert C, THUNNISSEN, Erik, HEIDEMAN, Daniëlle A. M, POSTMUS, Pieter E
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 2013
• Subjects: Adult; Antineoplastic agents; Base Sequence; Biological and medical sciences; Carbon Radioisotopes - chemistry; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - genetics; Erlotinib Hydrochloride; Exons; Female; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Male; Medical sciences; Middle Aged; Multimodal Imaging - methods; Mutation; Neoplasm Staging; Pharmacology. Drug treatments; Positron-Emission Tomography; Quinazolines - chemistry; Quinazolines - pharmacokinetics; Receptor, Epidermal Growth Factor - genetics; Receptor, Epidermal Growth Factor - metabolism; Tomography, X-Ray Computed; Radionuclide study; Antineoplastic agent; Evaluation; Enzyme; Tyrosine kinase inhibitor; Quinazoline derivatives; Transferases; Enzyme inhibitor; Epidermal growth factor receptor; In vivo; Erlotinib; Development; Genetics; Mutation; Protein-tyrosine kinase; Positron emission tomography; Emission tomography
• ISSN: 1078-0432; 1557-3265; 1557-3265
• DOI: 10.1158/1078-0432.ccr-12-0289

To evaluate whether, in patients with non-small cell lung carcinoma (NSCLC), tumor uptake of [(11)C]erlotinib can be quantified and imaged using positron emission tomography and to assess whether the level of tracer uptake corresponds with the presence of activating tumor EGF receptor (EGFR) mutations. Ten patients with NSCLCs, five with an EGFR exon 19 deletion, and five without were scanned twice (test retest) on the same day with an interval of at least 4 hours. Each scanning procedure included a low-dose computed tomographic scan, a 10-minute dynamic [(15)O]H(2)O scan, and a 1-hour dynamic [(11)C]erlotinib scan. Data were analyzed using full tracer kinetic modeling. EGFR expression was evaluated using immunohistochemistry. The quantitative measure of [(11)C]erlotinib uptake, that is, volume of distribution (V(T)), was significantly higher in tumors with activating mutations, that is, all with exon 19 deletions (median V(T), 1.76; range, 1.25-2.93), than in those without activating mutations (median V(T), 1.06; range, 0.67-1.22) for both test and retest data (P = 0.014 and P = 0.009, respectively). Good reproducibility of [(11)C]erlotinib V(T) was seen (intraclass correlation coefficient = 0.88). Intergroup differences in [(11)C]erlotinib uptake were not correlated with EGFR expression levels, nor tumor blood flow. [(11)C]erlotinib V(T) was significantly higher in NSCLCs tumors with EGFR exon 19 deletions.