Role of PET quantitation in the monitoring of cancer response to treatment: Review of approaches and human clinical trials.
Role of PET quantitation in the monitoring of cancer response to treatment: Review of approaches and human clinical trials.
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DOI：
10.1007/s40336-014-0071-1
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发表时间：
2014-08-01
影响因子：
2.1
通讯作者：
Mankoff, David A
中科院分区：
文献类型：
--
作者：
Doot, Robert K;McDonald, Elizabeth S;Mankoff, David A
肿瘤新陈代谢和细胞增殖的正电子发射断层扫描(PET)测量作为癌症治疗反应的标志越来越多地被研究，目的是将其用作患者治疗结果的预测指标--即替代结果测量。到目前为止，用于监测癌症治疗反应的主要PET放射性示踪剂是用于研究异常能量代谢的18F-脱氧葡萄糖(FDG)和用于检测细胞增殖的18F-氟胸苷(Flt)。FDG和Flt PET对癌症治疗反应的定量都被发现与患者的预后相关，主要是在单中心研究中。这篇综述的目的是总结常用的PET定量方法对PET方法量化癌症治疗反应的能力的影响。需要了解FDG和Flt摄取的生化和动力学，以及肿瘤过程相对于背景摄取的预期示踪剂摄取的知识，才能选择合适的PET定量方法进行试验，测试PET测量与患者预后之间的相关性。PET措施可能最终作为预测性生物标志物，能够指导个体化治疗，并通过早期识别无效治疗来改善患者结果和生活质量。PET还可以潜在地识别哪些患者可能是分子靶向药物的良好候选者，并监测这些个性化治疗的反应。
Positron emission tomography (PET) measures of cancer metabolism and cellular proliferation are increasingly being studied as markers of cancer response to treatment, with the goal of using them as predictors of patient therapeutic outcomes – i.e., as surrogate outcome measures. The primary PET radiotracers thus far used for monitoring response of cancer to treatment are 18F-fluorodeoxyglucose (FDG) for studying abnormal energy metabolism and 18F-fluorothymidine (FLT) for examining cell proliferation. Both FDG and FLT PET quantitation of cancer response to treatment have been found to correlate with patient outcomes, mostly in single-center studies. The aim of this review is to summarize the impact of commonly selected PET quantitation methods on the ability of PET measures to quantitate cancer response to treatment. An understanding of the biochemistry and kinetics of FDG and FLT uptake and knowledge of the expected tracer uptake by cancerous processes relative to background uptake are required to select appropriate PET quantitation methods for trials testing for correlations between PET measures and patient outcome. PET measures may eventually serve as predictive biomarkers capable of guiding individualized treatment and improving patient outcomes and quality of life by early identification of ineffective therapies. PET can also potentially identify patients who would be good candidates for molecularly targeted drugs and monitor response to these personalized therapies.