Galldiks Norbert, Werner Jan-Michael, Stetter Isabelle, Puhr Hannah C, Nakuz Thomas S, Stoffels Gabriele, Albert Nathalie L, Langen Karl-Josef, Lohmann Philipp, Preusser Matthias
Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany.
Institute of Neuroscience and Medicine (INM-3, INM-4), Research Center Juelich, Juelich, Germany.
Neurooncol Adv. 2024 Nov 29;6(1):vdae210. doi: 10.1093/noajnl/vdae210. eCollection 2024 Jan-Dec.
The phase-3 INDIGO trial demonstrated that the isocitrate dehydrogenase () inhibitor vorasidenib significantly prolonged progression-free survival and delayed intervention in patients with CNS WHO grade 2 gliomas. However, conventional MRI showed limited response, with only 11% of patients having objective responses. Studies suggest that serial PET imaging with radiolabeled amino acids, such as -(2-[ F]-fluoroethyl)-L-tyrosine (FET) PET, may provide earlier and more informative assessments of treatment response than MRI. In an initial experience with FET PET, 3 out of 5 patients showed metabolic response to vorasidenib. This highlights FET PET's potential to guide decision-making, though further trials are needed to confirm outcome benefits.
3期INDIGO试验表明,异柠檬酸脱氢酶(IDH)抑制剂沃拉西尼可显著延长中枢神经系统WHO 2级胶质瘤患者的无进展生存期并延迟干预。然而,传统MRI显示反应有限,只有11%的患者有客观反应。研究表明,使用放射性标记氨基酸的系列PET成像,如α-(2-[¹⁸F]-氟乙基)-L-酪氨酸(FET)PET,可能比MRI提供更早且更具信息性的治疗反应评估。在FET PET的初步经验中,5名患者中有3名对沃拉西尼有代谢反应。这突出了FET PET在指导决策方面的潜力,不过还需要进一步试验来证实其对预后的益处。