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Studies on optimal evaluation of the effect and recurrence of molecular-targeting therapy using positron emission tomography

正电子发射断层扫描分子靶向治疗疗效及复发优化评价研究

基本信息

批准号：
15591255
负责人：
ORIUCHI Noboru
金额：
$ 1.6万
依托单位：
Gunma University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

Molecular-targeted therapy is advantageous as compared with cytotoxic chemotherapy because it is specific to the target cells. Therapeutic effect is thought to reduce glucose metabolism of malignant cells and makes the uptake of [^<18>F] fluorodeoxyglucose (^<18>F-FDG) lower.Malignant potential of gastrointestinal stromal tumor (GIST) is not easily evaluable prior to the surgical procedure. Pathological analysis demonstrated that the uptake of ^<18>F-FDG by the tumor is related to the cellular proliferative fraction of the resected tumors. These results indicated that ^<18>F-FDG PET has a role to evaluate malignancy of GIST. Comparison of the reduction in the ^<18>F-FDG uptake with the effect of imatinib mesylate is under the investigation.Anti-CD20 monoclonal antibody is effective to malignant lymphoma. ^<18>F-FDG PET is useful for the staging and also the evaluation of antitumor efficacy and the prognosis of malignant lymphoma. In patients with effective therapy, the uptake of ^<18>F-FDG PET decreased even when CT showed residual tumor. These results indicate that ^<18>F-FDG PET has alternative role for the accurate evaluation of the therapeutic effect as compared with the standard method using CT.Bronchial adenocarcinoma with the mutation of epidermal growth factor receptor (EGFR) is highly predictive of the response to gefitinib therapy. Clinical trial of the utility of ^<18>F-FDG PET in the evaluation of the response to gefitinib in patients with lung cancer with EGFR mutation is underway.

与细胞毒性化疗相比，分子靶向治疗是有利的，因为它对靶细胞具有特异性。胃肠道间质瘤（gastrointestinal stromal tumor，GIST）的恶性潜能在手术前不易评估，因此GIST的治疗效果被认为是通过降低恶性细胞的糖代谢，降低[^<18>F]氟代脱氧葡萄糖（[^<18>F-FDG]）的摄取。病理学分析表明，肿瘤对~ 1F-FDG的摄取<18>与切除肿瘤的细胞增殖分数有关。结果提示：<18>~（13）F-FDGPET对胃肠道间质瘤的恶性程度有一定的诊断价值。抗<18>CD 20单克隆抗体对恶性淋巴瘤有效。~ 1F-FDGPET<18>对恶性淋巴瘤的分期、疗效评价及预后判断有重要意义。在有效治疗的患者中，<18>即使在CT显示肿瘤残留时，^ F-FDG PET的摄取也降低。这些结果表明，<18>与使用CT的标准方法相比，^ F-FDG PET在准确评估治疗效果方面具有替代作用。表皮生长因子受体（EGFR）突变的支气管腺癌对吉非替尼治疗的反应具有高度预测性。目前<18>正在进行使用13 F-FDG PET评估EGFR突变肺癌患者对吉非替尼的反应的临床试验。