WASHINGTON—Early metabolic imaging with positron emission tomography (PET) identifies responders to neoadjuvant chemotherapy for advanced adenocarcinoma of the esophagogastric junction, German researchers reported at the Society of Nuclear Medicine (SNM) meeting (abstract 93).

"This is the first study to apply PET results from early metabolic response assessment to clinical decision making in the treatment of common solid tumors," said Ken Herrmann, MD, of the Department of Nuclear Medicine at the Technical University in Munich. The study was initiated by Florian Lordick, MD, of the Department of Surgery.

Dr. Herrmann noted that "the outcome for metabolic responders turned out to be remarkably favorable, compared to metabolic nonresponders."

Who Will Benefit?

The study, part of the MUNICON trial, was designed to determine whether PET could discern between those patients who would benefit from neoadjuvant chemotherapy and those who would not respond and therefore lose valuable time and suffer side effects with no corresponding benefit. Researchers used 18-fluorodeoxyglucose (FDG) with PET to make their decisions.

Between May 2002 and August 2005, 111 patients were enrolled in the study. Eligible patients had potentially R0 resectable adenocarcinoma of the esophagogastric junction determined by endoscopic ultrasound, CT, and FDG-PET.

Patients with a greater than 35% decrease of tumor standardized uptake value (SUV) after 2 weeks of neoadjuvant platin/5-fluorouracil-based chemotherapy, compared with baseline, were defined as metabolic responders. They continued on chemotherapy for 12 weeks before surgery.