Aims: The adverse events during antiangiogenic therapy inevitably influence a patient's quality of life. Therefore, biomarkers to identify patients who will experience adverse events would be very valuable in treatment planning.
Materials And Methods: Between September 2016 and December 2019, patients scheduled for single-agent apatinib were prospectively enrolled and underwent F-RGD positron emission tomography/computed tomography (PET/CT) pre-treatment. Maximum and mean standard uptake values (SUV and SUV) were obtained from thyroid, liver, gastric cardia, gastric body, gastric pylorus and spleen. Statistical methods included the independent sample t-test, Mann-Whitney U-test, receiver operating characteristic curve analysis and chi-squared test.
Results: In total, 60 patients were initially screened and consented for F-RGD PET/CT scans. The three most frequent adverse events were fatigue (50%), hypertension (36%) and nausea (36%), accounting for 72% in the 50 patients included in the analysis. SUV and SUV of thyroid and liver were significantly associated with fatigue, whereas SUV and SUV of thyroid and spleen were significantly associated with hypertension and SUV and SUV of thyroid and gastric cardia were significantly associated with nausea (all P < 0.05). The most significant predictors of adverse events were F-RGD SUV for fatigue (area under the curve [AUC] = 0.682), SUV for hypertension (AUC = 0.688) and SUV for nausea (AUC = 0.698). Classified by the cut-off values for SUV (4.57), SUV (6.77) and SUV (2.10), patients with low RGD SUV in liver, spleen and gastric cardia had statistically higher incidence of fatigue (67.9% versus 27.3%, P = 0.002), hypertension (55.6% versus 13.0%, P = 0.004) and nausea (61.1% versus 21.9%, P = 0.006).
Conclusions: Low pre-treatment F-RGD uptake in the liver, spleen and gastric cardia were predictive of the adverse events fatigue, hypertension and nausea during apatinib treatment, respectively.
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| http://dx.doi.org/10.1016/j.clon.2022.01.002 | DOI Listing |
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