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Molecular Cancer Targets. Wester H Clin Cancer Res 2007;13:3470-3481. Strengths of PET in Oncology. 1. Improved Tumor Detection. 2. Therapy Response Evaluation. Ovarian carcinoma. CT baseline. Lymphoma. Only PET shows malignant intra-thoracic LN. CT post R/.
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Molecular Cancer Targets Wester H Clin Cancer Res 2007;13:3470-3481
Strengths of PET in Oncology 1. Improved Tumor Detection 2. Therapy Response Evaluation Ovariancarcinoma CT baseline Lymphoma Only PET shows malignantintra-thoracic LN CT post R/ 3. Tumor Characterisation 4. Stromal Characterisation PET Baseline PET post R/ Hypoxia TumourVasculature Carroll & Ashcroft , ExpRev Mol Med, 2005 Bergers & Benjamin, Nat RevCancer 2003 Wester, Clin Cancer Res 2007
Characterisation of CancerHallmarks Apoptosis Imaging Growth Receptor Imaging Imaging TGF-βsignalling Her2/neu Dijkers et al, JNM 2009: Kang et al, PNAS 2005 No Apoptosis Apoptosis Imaging Tissue invasion αVβ6 - 5nm affinityligand Normal Blockage Bauwens et al., 2009, abstract Interreg Imaging Angiogenesis Hanahan & Weinberg, Cell 2000 Hausner et al.,Cancer Res 2009 Proliferation Imaging Imaging Metastasis Deroose et al., 2010, to be submitted Wester H Clin Cancer Res 2007 Deroose et al., JNM 2007 Hanahanand Weinberg, Cell 2000
Evaluation of 11C-Choline PET/CT in LocallyAdvanced Prostate Cancer Better Cancer Staging with FDG-PET/CT Novel PET Tracers for Cancer Diagnosis CT: Normal CT PET/CT PET Evaluation of Novel 68Ga-Labeled Receptor Ligand PET/CT to DetectOvarianCancer Ovariancarcinoma CT: Normal Malignant LN Malignant LN FDG-PET /CT: Current State of the art Folate Receptor (FR) FR Scintigraphy PET: MalignantLymphNode 68Ga-FR Ligand BUT … FDG is not tumor specific Some tumors do notaccumulate FDG Needforassessement of non-cytoreductivetherapies • First in man • Dosimetry • 30 patients • Correlationwithpost-ophistology http://www.enzolifesciences.com/ Fisher et al, JNM 2008
Assessement of 90Y-DOTATOC Peptide Receptor Radiation Therapy with 68GA-DOTATOC PET/CT Therapy Response Evaluation with FDG-PET/CT PET and Therapy Response Assessement PET CT SS Receptor in NET Post R/ Baseline Baseline 68Ga-DOTATOC PET/CT Assessement of Anti-Angiogenic Therapy withAngiogenesis PET “Theranostic” 68Ga/90Y-DOTATOC www.ihcworld.com FDG-PET /CT: Current State of the art in lymphoma Cured ResidualMass Post R/ Post R/ Baseline BUT … FDG is not tumor specific Some tumors do notaccumulate FDG Response without complete remission in solid tumors Needforassessement of non-cytoreductivetherapies Cancer BloodvesselLigand Bevacuzimab Vessel PET Baseline Post R/ Deroose et al., 2010, to be submitted
MulticenterEvaluation of PET as Response Predictor forAnti-EGFRTherapy in MetastaticColorectalCancer Baseline 2 weeks Baseline Prospective, multicenter trial to asses response to Cetuximabwith PET PET Non-Responder Survival 83 days PET Responder Van Cutsem et al, NEJM 2009 5 PET centers TracerProduction in Leuven Survival 351 days
OngoingProjects in Oncology Academic Therapy Response Evaluation (TRE) in LungCancer (NSCLC) Diagnosticperformance of Choline PET in Prostate Cancer TR to Anti-angiogenicdrugs in ColorectalCancer TRE in NET afterPeptide Receptor Radiation Therapy TRE in Pediatric Hodgkin’s Lymphoma (HL) TRE – RT planning in Colorectal Cancer Commercial TRE to Medi551 in Non-Hodgkin Lymphoma (NHL) TRE to ProteasomeInhibitors in NHL TRE to Monoclonal Antibody in HL TRE to Monoclonal Antibody in NHL TRE to Anti-hormonal Therapy in Endometrial Cancer TRE to Small Molecule Her2Neu TKI in Breast Cancer TRE to Small Molecule Aurora Kinase Inhibitors in Sarcoma TRE to Multitarget Small Molecule TKI in Sarcoma Novel PET Tracer for Ovarian Cancer TR to Anti-angiogenic Drugs in ColorectalCancer