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Background: Positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F-FDG) has been studied in thymic epithelial tumors. We evaluated the usefulness of F-FDG PET for monitoring after treatment in unresectable thymic epithelial tumors. Method: Twelve patients with unresectable/metastatic thymic epithelial tumors underwent PET study with F-FDG before and after chemotherapy or radiotherapy. Response and survival were analyzed according to the ratio of the peak standardized uptake value (SUV) of the tumor to the mean SUV of the mediastinum (T/M ratio). Results: Partial response (PR) evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) was noted in 4 (33%) of 12 patients, and partial metabolic response (PMR) was observed in 6 (50%) of 12 patients. PR was observed in 4 of 6 patients with PMR. In 6 patients with any response, the T/M ratio at post-treatment was significantly lower than at baseline ( p = 0.0017). In 6 patients with stable disease (SD), stable metabolic disease (SMD) was observed in 5 by use of F-FDG PET. No statistically significant difference of F-FDG uptake between at baseline and post-therapy was observed in 6 patients with SD ( p = 0.4157) and SMD ( p = 0.8419). Although the overall survival after treatment showed no statistically significant difference between PMR and SMD or progressive metabolic disease in the whole group of patients including thymoma, a statistically significant difference in the overall survival was observed between 5 patients with PMR and 5 patients with non-PMR ( p = 0.0280). Conclusion: Our preliminary study suggests that F-FDG PET is useful for monitoring response and outcome after treatment in unresectable thymic epithelial tumors. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) metastasis from non-small-cell lung cancer (NSCLC) is relatively rare. As most patients with GI metastasis are diagnosed on the occasion of serious complications, such as ileus or perforation, the appropriate diagnosis is important. Here, we report a case of NSCLC metastatic to the small intestine diagnosed at initial staging using ¹⁸F-fluorodeoxyglucose positron emission tomography. [ABSTRACT FROM AUTHOR]

Abstract: Background: Pulmonary pleomorphic carcinoma is a rare epithelial tumor, and little is also known about the information on the usefulness of 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET). Therefore, we conducted the study including the underlying biologic analysis of 18F-FDG uptake. Methods: Fifteen patients with pulmonary pleomorphic carcinoma who underwent 18F-FDG PET before treatment were included in this study. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (Glut1); glucose transporter 3 (Glut3); hypoxia-inducible factor-1 alpha (HIF-1α); cell proliferation (Ki-67 labeling index); vascular endothelial growth factor (VEGF); microvessels (CD34); cell cycle control marker (p53); and apoptosis marker (bcl-2). These parameters were correlated with a control group of patients with other non-small cell lung cancer (NSCLC) (n =33). Results: The maximal standardized uptake value (SUVmax) of the primary tumors in 15 patients ranged from 6.1 to 26.8 (median 19.3). There were positive correlation between 18F-FDG uptake and Glut1 (p =0.0016), Glut3 (p =0.0080), VEGF (p =0.0048), and microvessel density (MVD) (p =0.0005). HIF-1α, p53 and bcl-2 showed no positive correlation with 18F-FDG uptake. 18F-FDG uptake, Glut1, Glut3, HIF-1α, VEGF and Ki-67 were significantly higher in patients with pulmonary pleomorphic carcinoma than those with other NSCLC. Conclusion: 18F-FDG uptake in pulmonary pleomorphic carcinoma is closely associated with the presence of glucose metabolism (Glut1 and Glut3) and angiogenesis (VEGF and MVD). The relationship between 18F-FDG uptake and these biomarkers may lead to a more rational use of PET scan in pulmonary pleomorphic carcinoma. [ABSTRACT FROM AUTHOR]

Summary: Purpose: The objective of this study was to assess the value of 18F-FDG PET in thymic epithelial tumors according to the WHO histologic classification and to evaluate its potential for differentiating the grade of malignancy in thymic epithelial tumors. Materials and methods: Thirty-six patients with a thymic epithelial tumor who underwent 18F-FDG PET examination before treatment were enrolled in the present study. The T/M ratio, which is the ratio of the peak standardized uptake value (SUV) of the tumor to the mean SUV of mediastinum, was compared in subgroups of a simplified WHO histological classification; low-risk thymoma (Types A, AB and B1), high-risk thymoma (Types B2 and B3), and thymic carcinoma. Results: Tumors included 15 low-risk thymomas, 10 high-risk thymomas and 11 thymic carcinomas. Upon visual inspection, all tumors showed 18F-FDG accumulation and the mean T/M ratio in these three subgroups was 2.64, 4.29 and 8.90, respectively. The differences between the three subgroups were statistically significant (low-risk vs. high-risk: p =0.01, high-risk vs. thymic carcinoma: p =0.01). Conclusion: A significant relationship was seen between 18F-FDG PET accumulation and histologic subtype in thymic epithelial tumors when they were classified into three groups. PET may be useful for predicting the grade of malignancy in thymic epithelial tumors. [Copyright &y& Elsevier]

Purpose: EGFR-tyrosine kinase inhibitor (TKI) is a standard first-line therapy for activated EGFR -mutated non-small cell lung cancer (NSCLC). Treatment options for patients with acquired EGFR-TKI resistance are limited. HER3 mediates EGFR-TKI resistance. Clinical trials of the HER3-targeting antibody-drug conjugate patritumab deruxtecan (HER3-DXd) demonstrated its anticancer activity in EGFR -mutated NSCLC; however, the mechanisms that regulate HER3 expression are unknown. This study was conducted with the aim to clarify the mechanisms underlying HER3 regulation in EGFR -mutated NSCLC tumors and explored the strategy for enhancing the anticancer activity of HER3-DXd in EGFR -mutated NSCLC., Experimental Design: Paired tumor samples were obtained from 48 patients with EGFR -mutated NSCLC treated with EGFR-TKI(s). HER3 expression was immunohistochemically quantified with H-score, and genomic alteration and transcriptomic signature were tested in tumors from pretreatment to post-EGFR-TKI resistance acquisition. The anticancer efficacy of HER3-DXd and osimertinib was evaluated in EGFR -mutated NSCLC cells., Results: We showed augmented HER3 expression in EGFR -mutated tumors with acquired EGFR-TKI resistance compared with paired pretreatment samples. RNA sequencing revealed that repressed PI3K/AKT/mTOR signaling was associated with HER3 augmentation, especially in tumors from patients who received continuous EGFR-TKI therapy. An in vitro study also showed that EGFR-TKI increased HER3 expression, repressed AKT phosphorylation in multiple EGFR -mutated cancers, and enhanced the anticancer activity of HER3-DXd., Conclusions: Our findings help clarify the mechanisms of HER3 regulation in EGFR -mutated NSCLC tumors and highlight a rationale for combination therapy with HER3-DXd and EGFR-TKI in EGFR -mutated NSCLC., (©2021 American Association for Cancer Research.)

Background: Neo-adjuvant chemotherapy(NAC)may affect hormone receptor(HR)and human epidermal growth factor receptor 2(HER2)status in breast cancer patients. However, the correlation between recurrence rates and this status change remains unclear., Methods: We evaluated 70 consecutive breast cancer patients receiving NAC with anthracyclines and taxanes, with or without trastuzumab, between January 2005 and May 2012. Pre-treatment core needle biopsy samples and specimens obtained after surgery were tested to determine HR and HER2 status. The relationship between HR and HER2 status changes and recurrence rates was then assessed., Results: Pathological complete response(pCR)was observed in 13 cases and non-pCR was observed in 57 cases. Of the non-pCR cases, HR-positive status changed to HR-negative status in 6.3% of patients, but a change from negativity to positivity was not observed. HER2-positive status changed to HER2-negative status in 48.0% of patients, and a change from negativity to positivity was observed in 12.5% of cases. The recurrence rate among patients with conversion to a HR-negative status was 0%and that among patients with conversion to a HER2-negative status was 25.0%., Conclusion: Recurrence rates were not significantly associated with HR and HER2 status conversion after NAC. Future research is warranted to confirm out results.

Background: In recent years, the incidence of carcinomatous meningitis (CM) in lung adenocarcinoma has been rising. However, it remains unclear which treatment strategies improve the outcome of these patients., Patients and Methods: We retrospectively reviewed data for 67 lung adenocarcinoma patients diagnosed with CM between September 2002 and March 2011 in order to identify factors which would improve prognosis., Results: In multivariate analysis, the female gender, a good performance status (PS) 0-2 and the mutant epidermal growth factor receptor (EGFR) gene were identified as factors associated with a favorable prognosis. The survival time was significantly prolonged for patients treated with EGFR-tyrosine kinase inhibitors (TKIs) (240 vs. 57 days, p<0.0001) and for patients who underwent radiotherapy of the central nervous system (CNS) (201 vs. 76 days, p=0.0038) after diagnosis of CM. The median survival time (MST) of patients treated with gefitinib before diagnosis of CM and with erlotinib after diagnosis was significantly longer than the MST of patients treated with gefitinib both before and after the diagnosis of CM (407 vs. 205 days, p=0.0015). Patients treated with both radiotherapy for CNS and EGFR-TKI had longer survival compared to patients without radiotherapy for the CNS (379 vs. 122 days, p=0.032)., Conclusion: EGFR-TKI combined with radiotherapy may be a therapeutic approach capable of improving the prognosis of patients with lung adenocarcinoma with CM harboring the EGFR gene mutation.

Background: Docetaxel is a well tolerated chemotherapy for non-small cell lung cancer (NSCLC). However, few studies have investigated interstitial lung disease (ILD) associated with docetaxel. The purpose is to describe the incidence of this complication by using NSCLC patients., Patients and Methods: Between September 2002 and March 2008, 392 patients with advanced NSCLC were treated with docetaxel and we retrospectively reviewed the radiography. In total, 18 patients subsequently developed ILD associated with docetaxel., Results: The incidence of ILD associated with docetaxel was 4.6%. In treated patients who showed an interstitial change on chest computed tomography (CT), the incidence was very high (25.9%). Chest radiograph showed diffuse and bilateral ground-glass appearance patterns., Conclusion: Pre-existing interstitial change on CT was associated with a higher incidence of ILD (25.9%) among NSCLC patients treated with docetaxel. We don't recommend administering docetaxel for the patients with pre-existing interstitial change.