In a recent study, researchers say a better understanding of certain diagnostic criteria could result in more targeted treatments for malignant mesothelioma.
In a recent published report, doctors from the medical school at Dicle University in Diyarbakir, Turkey measured the relationship between PET-CT scan results and survival in 177 patients with malignant pleural mesothelioma. The patients were diagnosed between April 2007 and April 2011. They had a mean age of 55.4 and most (56%) were male. Patients in the study all had FDG PET-CT scans before beginning their mesothelioma treatment.
FDG PET-CT scanning is a powerful imaging tool for mesothelioma and other cancers that combines a radioactive tracer with a combination of positron emission tomography and computed tomography scanning. Because it is a glucose analog, the FDG tracer is taken up in a larger amount by cells with a higher rate of metabolism, which includes the majority of cancer cells. While the FDT PET scan produces an image of cellular activity, the CT scan creates a three dimensional image of a tumor by assembling multiple radiographic ‘slices.’ Together, the two tests can give doctors valuable information about a patient’s mesothelioma.
When the FDG-PET/CT results of the 177 Turkish patients were analyzed, it revealed the following data about mesothelioma prognosis.
• Men with mesothelioma were 5.3 times more likely to have a poor prognosis than woman.
• Having a performance score (a measure of overall health) less than 60 meant the mesothelioma patient was more than twice as likely to have a poor prognosis.
• Patients on “best supportive care” (symptom management only) were 25.4 times more likely to have a poor prognosis.
• Patients with stage III or IV mesothelioma, meaning the mesothelioma has spread to distant lymph nodes or beyond, increased poor prognosis by approximately 11 times.
• A standardized uptake value (a measure of how much of the radioactive tracer is taken up by cells) greater than 5 increased a poor prognosis 4.34 times.
The report concluded that these factors, revealed by FDG PET-CT, are all “significant predictors of survival” in mesothelioma. The authors suggest that studying them may help research scientists improve treatment for this hard-to-treat cancer. The report summary concludes, “An understanding of the importance of these markers for malignant pleural mesothelioma prognosis should allow targeted treatments to be developed.”
Abakay, A, et al, “relationship between 18 FDG PET-CT findings and the survival of 177 patients with malignant pleural mesothelioma”, May 2013, European Reviews for Medical and Pharmacological Sciences.