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EF5 PET of Tumor Hypoxia: A Predictive Imaging Biomarker of Response to Stereotactic Ablative Radiotherapy (SABR) for Early Lung Cancer

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Technical Report,15 Aug 2014,14 Aug 2015

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Stanford University Stanford United States

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Stereotactic ablative radiotherapy SABR has become a new standard of care for early stage lung cancer in patients who arenot candidates for surgery because of excessive surgical risk, and will be an important treatment option for a growing segmentof patients with lung cancer. This is particularly true as lung cancer screening efforts are expected to diagnose a greaterproportion of lung cancers at earlier stages, yet the aging of the population will lead to a greater proportion of patients havingcomorbidities that increase surgical risk. Tumor hypoxia is a major known mechanism of radiation resistance and is especiallyexpected to affect very short courses of radiation as in SABR. Imaging using a third generation hypoxia PET agent, 18F-EF5, isa promising approach for noninvasive hypoxia measurement that needs to be validated in the clinical setting.Our objectives are 1 to understand the prevalence of hypoxia detectable by imaging in early stage NSCLC 2 to validate18F-EF5 PET as an indicator of tumor oxygenation status in this patient population and 3 to evaluate 18F-EF5 PET as aprognostic imaging biomarker for local primary tumor control after SABR.

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