Non Small Cell Lung Cancer (NSCLC) is the leading cause of tumor-related deaths in the world, with over one million patients dying from the disease annually. Deciding on a line of treatment and determining its efficacy for specific patients remains one of the keys to effectively treating the disease. However, using standard anatomical imaging techniques, tracking the effectiveness of ongoing treatment can become increasingly difficult over time. This is because the treatment itself takes time to affect the size of the tumor and early detection becomes increasingly difficult.

Functional imaging techniques, on the other hand, offer an advantage over anatomical imaging techniques, providing insights into the progress of treatment within as few as 14 days. Imaging biomarkers make it possible to assess the responsiveness or the aggressiveness of a tumor, which helps doctors focus in on whether a specific line of therapy is effective, or change it in the early stages of treatment if the patient stops responding. A long-term benefit of such a step would be halting unnecessary damage to healthy cells as a result of tumor treatment that was otherwise unresponsive, and with time being a pivotal factor, helping healthcare professionals pursue alternative therapeutic options.

In an effort to improve the assessment of lung cancer treatment efficacy, the European Organization for Research and Treatment of Cancer (EORTC) has started enrolling patients for a multicenter, non-randomized, single arm imaging trial and will enroll approximately 40 patients from eight institutions located in three countries — Italy, The Netherlands, and the United Kingdom — to qualify and quantify imaging biomarkers for early detection of tumors and their responsiveness to various treatment regimes. The trial specifically aims to estimate and assess the benefits of 3-deoxy-3-[18F]fluorothymidine positron emission tomography (FLT-PET) and diffusion weighted magnetic resonance imaging (DW-MRI) in patients with early stage non-small cell lung cancer treated with pre-operative chemotherapy followed by surgery.

Study co-ordinator Dr. Nandita deSouza of the Royal Marsden Hospital-Sutton explained, “FLT-PET will be used to monitor tumor cell proliferation and DWI-MRI to monitor tumor cell death. The values obtained from the scan at the beginning of treatment will be compared with those obtained two weeks later as well as with pathological observations such as the percentage of viable residual tumor cells measured in surgical specimens. This should allow researchers to determine whether imaging can help qualify tumor cell proliferation and tumor cell death in patients with operable non-small cell lung cancer.”