1
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Krebs S, Veach DR, Carter LM, Grkovski M, Fornier M, Mauro MJ, Voss MH, Danila DC, Burnazi E, Null M, Staton K, Pressl C, Beattie BJ, Zanzonico P, Weber WA, Lyashchenko SK, Lewis JS, Larson SM, Dunphy MPS. First-in-Humans Trial of Dasatinib-Derivative Tracer for Tumor Kinase-Targeted PET. J Nucl Med 2020; 61:1580-1587. [PMID: 32169913 PMCID: PMC8524123 DOI: 10.2967/jnumed.119.234864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 03/05/2020] [Indexed: 01/20/2023] Open
Abstract
We developed a first-of-kind dasatinib-derivative imaging agent, 18F-SKI-249380 (18F-SKI), and validated its use for noninvasive in vivo tyrosine kinase-targeted tumor detection in preclinical models. In this study, we assessed the feasibility of using 18F-SKI for PET imaging in patients with malignancies. Methods: Five patients with a prior diagnosis of breast cancer, renal cell cancer, or leukemia underwent whole-body PET/CT imaging 90 min after injection of 18F-SKI (mean, 241.24 ± 116.36 MBq) as part of a prospective study. In addition, patients underwent either a 30-min dynamic scan of the upper abdomen including, at least partly, cardiac left ventricle, liver, spleen, and kidney (n = 2) or three 10-min whole-body PET/CT scans (n = 3) immediately after injection and blood-based radioactivity measurements to determine the time course of tracer distribution and facilitate radiation dose estimates. A subset of 3 patients had a delayed whole-body PET/CT scan at 180 min. Biodistribution, dosimetry, and tumor uptake were quantified. Absorbed doses were calculated using OLINDA/EXM 1.0. Results: No adverse events occurred after injection of 18F-SKI. In total, 27 tumor lesions were analyzed, with a median SUVpeak of 1.4 (range, 0.7-2.3) and tumor-to-blood ratios of 1.6 (range, 0.8-2.5) at 90 min after injection. The intratumoral drug concentrations calculated for 4 reference lesions ranged from 0.03 to 0.07 nM. In all reference lesions, constant tracer accumulation was observed between 30 and 90 min after injection. A blood radioassay indicated that radiotracer clearance from blood and plasma was initially rapid (blood half-time, 1.31 ± 0.81 min; plasma, 1.07 ± 0.66 min; n = 4), followed variably by either a prolonged terminal phase (blood half-time, 285 ± 148.49 min; plasma, 240 ± 84.85 min; n = 2) or a small rise to a plateau (n = 2). Like dasatinib, 18F-SKI underwent extensive metabolism after administration, as evidenced by metabolite analysis. Radioactivity was predominantly cleared via the hepatobiliary route. The highest absorbed dose estimates (mGy/MBq) in normal tissues were to the right colon (0.167 ± 0.04) and small intestine (0.153 ± 0.03). The effective dose was 0.0258 mSv/MBq (SD, 0.0034 mSv/MBq). Conclusion:18F-SKI demonstrated significant tumor uptake, distinct image contrast despite low injected doses, and rapid clearance from blood.
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Affiliation(s)
- Simone Krebs
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Darren R Veach
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Lukas M Carter
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Monica Fornier
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Michael J Mauro
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Martin H Voss
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Daniel C Danila
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Eva Burnazi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Manda Null
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kevin Staton
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christina Pressl
- Laboratory of Neural Systems, Rockefeller University, New York, New York
| | - Bradley J Beattie
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pat Zanzonico
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Wolfgang A Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany; and
| | - Serge K Lyashchenko
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, New York
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, New York
| | - Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
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2
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Dunphy MPS, Pressl C, Pillarsetty N, Grkovski M, Modi S, Jhaveri K, Norton L, Beattie BJ, Zanzonico PB, Zatorska D, Taldone T, Ochiana SO, Uddin MM, Burnazi EM, Lyashchenko SK, Hudis CA, Bromberg J, Schöder HM, Fox JJ, Zhang H, Chiosis G, Lewis JS, Larson SM. First-in-Human Trial of Epichaperome-Targeted PET in Patients with Cancer. Clin Cancer Res 2020; 26:5178-5187. [PMID: 32366671 PMCID: PMC7541604 DOI: 10.1158/1078-0432.ccr-19-3704] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/30/2020] [Accepted: 04/30/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE 124I-PU-H71 is an investigational first-in-class radiologic agent specific for imaging tumor epichaperome formations. The intracellular epichaperome forms under cellular stress and is a clinically validated oncotherapeutic target. We conducted a first-in-human study of microdose 124I-PU-H71 for PET to study in vivo biodistribution, pharmacokinetics, metabolism, and safety; and the feasibility of epichaperome-targeted tumor imaging. EXPERIMENTAL DESIGN Adult patients with cancer (n = 30) received 124I-PU-H71 tracer (201±12 MBq, <25 μg) intravenous bolus followed by PET/CT scans and blood radioassays. RESULTS 124I-PU-H71 PET detected tumors of different cancer types (breast, lymphoma, neuroblastoma, genitourinary, gynecologic, sarcoma, and pancreas). 124I-PU-H71 was retained by tumors for several days while it cleared rapidly from bones, healthy soft tissues, and blood. Radiation dosimetry is favorable and patients suffered no adverse effects. CONCLUSIONS Our first-in-human results demonstrate the safety and feasibility of noninvasive in vivo detection of tumor epichaperomes using 124I-PU-H71 PET, supporting clinical development of PU-H71 and other epichaperome-targeted therapeutics.
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Affiliation(s)
- Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Christina Pressl
- Laboratory of Neural Systems, The Rockefeller University, New York, New York
| | - Nagavarakishore Pillarsetty
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shanu Modi
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Komal Jhaveri
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Larry Norton
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bradley J Beattie
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pat B Zanzonico
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Danuta Zatorska
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Tony Taldone
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Stefan O Ochiana
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mohammad M Uddin
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eva M Burnazi
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Serge K Lyashchenko
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacqueline Bromberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Heiko M Schöder
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Josef J Fox
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hanwen Zhang
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gabriela Chiosis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- Chemical Biology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
- Radiochemistry and Molecular Imaging Probes Core, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pharmacology, Weill Cornell Medical College, New York, New York
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology, Weill Cornell Medical College, New York, New York
- Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Pharmacology, Weill Cornell Medical College, New York, New York
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3
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Hellmann MD, Nabet BY, Rizvi H, Chaudhuri AA, Wells DK, Dunphy MPS, Chabon JJ, Liu CL, Hui AB, Arbour KC, Luo J, Preeshagul IR, Moding EJ, Almanza D, Bonilla RF, Sauter JL, Choi H, Tenet M, Abu-Akeel M, Plodkowski AJ, Perez Johnston R, Yoo CH, Ko RB, Stehr H, Gojenola L, Wakelee HA, Padda SK, Neal JW, Chaft JE, Kris MG, Rudin CM, Merghoub T, Li BT, Alizadeh AA, Diehn M. Circulating Tumor DNA Analysis to Assess Risk of Progression after Long-term Response to PD-(L)1 Blockade in NSCLC. Clin Cancer Res 2020; 26:2849-2858. [PMID: 32046999 DOI: 10.1158/1078-0432.ccr-19-3418] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Treatment with PD-(L)1 blockade can produce remarkably durable responses in patients with non-small cell lung cancer (NSCLC). However, a significant fraction of long-term responders ultimately progress and predictors of late progression are unknown. We hypothesized that circulating tumor DNA (ctDNA) analysis of long-term responders to PD-(L)1 blockade may differentiate those who will achieve ongoing benefit from those at risk of eventual progression. EXPERIMENTAL DESIGN In patients with advanced NSCLC achieving long-term benefit from PD-(L)1 blockade (progression-free survival ≥ 12 months), plasma was collected at a surveillance timepoint late during/after treatment to interrogate ctDNA by Cancer Personalized Profiling by Deep Sequencing. Tumor tissue was available for 24 patients and was profiled by whole-exome sequencing (n = 18) or by targeted sequencing (n = 6). RESULTS Thirty-one patients with NSCLC with long-term benefit to PD-(L)1 blockade were identified, and ctDNA was analyzed in surveillance blood samples collected at a median of 26.7 months after initiation of therapy. Nine patients also had baseline plasma samples available, and all had detectable ctDNA prior to therapy initiation. At the surveillance timepoint, 27 patients had undetectable ctDNA and 25 (93%) have remained progression-free; in contrast, all 4 patients with detectable ctDNA eventually progressed [Fisher P < 0.0001; positive predictive value = 1, 95% confidence interval (CI), 0.51-1; negative predictive value = 0.93 (95% CI, 0.80-0.99)]. CONCLUSIONS ctDNA analysis can noninvasively identify minimal residual disease in patients with long-term responses to PD-(L)1 blockade and predict the risk of eventual progression. If validated, ctDNA surveillance may facilitate personalization of the duration of immune checkpoint blockade and enable early intervention in patients at high risk for progression.
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Affiliation(s)
- Matthew D Hellmann
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. .,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York.,Parker Center for Cancer Immunotherapy, San Francisco, California
| | - Barzin Y Nabet
- Department of Radiation Oncology, Stanford University, Stanford, California.,Stanford Cancer Institute, Stanford University, Stanford, California
| | - Hira Rizvi
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aadel A Chaudhuri
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel K Wells
- Parker Center for Cancer Immunotherapy, San Francisco, California
| | - Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jacob J Chabon
- Department of Radiation Oncology, Stanford University, Stanford, California.,Stanford Cancer Institute, Stanford University, Stanford, California
| | - Chih Long Liu
- Stanford Cancer Institute, Stanford University, Stanford, California.,Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Angela B Hui
- Department of Radiation Oncology, Stanford University, Stanford, California.,Stanford Cancer Institute, Stanford University, Stanford, California
| | - Kathryn C Arbour
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jia Luo
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Isabel R Preeshagul
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Everett J Moding
- Department of Radiation Oncology, Stanford University, Stanford, California.,Stanford Cancer Institute, Stanford University, Stanford, California
| | - Diego Almanza
- Department of Radiation Oncology, Stanford University, Stanford, California.,Stanford Cancer Institute, Stanford University, Stanford, California
| | - Rene F Bonilla
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Jennifer L Sauter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hyejin Choi
- Ludwig Collaborative and Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Megan Tenet
- Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mohsen Abu-Akeel
- Ludwig Collaborative and Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew J Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rocio Perez Johnston
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christopher H Yoo
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Ryan B Ko
- Department of Radiation Oncology, Stanford University, Stanford, California
| | - Henning Stehr
- Department of Pathology, Stanford University, Stanford, California
| | - Linda Gojenola
- Department of Pathology, Stanford University, Stanford, California
| | - Heather A Wakelee
- Stanford Cancer Institute, Stanford University, Stanford, California.,Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Sukhmani K Padda
- Stanford Cancer Institute, Stanford University, Stanford, California.,Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Joel W Neal
- Stanford Cancer Institute, Stanford University, Stanford, California.,Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Jamie E Chaft
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark G Kris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charles M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Taha Merghoub
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Parker Center for Cancer Immunotherapy, San Francisco, California.,Ludwig Collaborative and Swim Across America Laboratory, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bob T Li
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell School of Medicine, New York, New York.,Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ash A Alizadeh
- Stanford Cancer Institute, Stanford University, Stanford, California. .,Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University, Stanford, California
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University, Stanford, California. .,Stanford Cancer Institute, Stanford University, Stanford, California.,Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, California
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Pillarsetty N, Jhaveri K, Taldone T, Caldas-Lopes E, Punzalan B, Joshi S, Bolaender A, Uddin MM, Rodina A, Yan P, Ku A, Ku T, Shah SK, Lyashchenko S, Burnazi E, Wang T, Lecomte N, Janjigian Y, Younes A, Batlevi CW, Guzman ML, Roboz GJ, Koziorowski J, Zanzonico P, Alpaugh ML, Corben A, Modi S, Norton L, Larson SM, Lewis JS, Chiosis G, Gerecitano JF, Dunphy MPS. Paradigms for Precision Medicine in Epichaperome Cancer Therapy. Cancer Cell 2019; 36:559-573.e7. [PMID: 31668946 PMCID: PMC6996250 DOI: 10.1016/j.ccell.2019.09.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 12/17/2022]
Abstract
Alterations in protein-protein interaction networks are at the core of malignant transformation but have yet to be translated into appropriate diagnostic tools. We make use of the kinetic selectivity properties of an imaging probe to visualize and measure the epichaperome, a pathologic protein-protein interaction network. We are able to assay and image epichaperome networks in cancer and their engagement by inhibitor in patients' tumors at single-lesion resolution in real time, and demonstrate that quantitative evaluation at the level of individual tumors can be used to optimize dose and schedule selection. We thus provide preclinical and clinical evidence in the use of this theranostic platform for precision medicine targeting of the aberrant properties of protein networks.
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Affiliation(s)
| | - Komal Jhaveri
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Tony Taldone
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Eloisi Caldas-Lopes
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Blesida Punzalan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Suhasini Joshi
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Alexander Bolaender
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Mohammad M Uddin
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Anna Rodina
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Pengrong Yan
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Anson Ku
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Thomas Ku
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Smit K Shah
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Serge Lyashchenko
- Radiochemistry and Molecular Imaging Probes Core, Sloan Kettering Institute, New York, NY 10065, USA
| | - Eva Burnazi
- Radiochemistry and Molecular Imaging Probes Core, Sloan Kettering Institute, New York, NY 10065, USA
| | - Tai Wang
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Nicolas Lecomte
- Gastrointestinal Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Yelena Janjigian
- Gastrointestinal Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Anas Younes
- Lymphoma Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Connie W Batlevi
- Lymphoma Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Monica L Guzman
- Division of Hematology and Medical Oncology, Leukemia Program, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Gail J Roboz
- Division of Hematology and Medical Oncology, Leukemia Program, Weill Cornell Medicine/New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Jacek Koziorowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Pat Zanzonico
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mary L Alpaugh
- Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Adriana Corben
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Shanu Modi
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Larry Norton
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Program in Molecular Pharmacology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Program in Molecular Pharmacology, Sloan Kettering Institute, New York, NY 10065, USA
| | - Gabriela Chiosis
- Breast Cancer Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Program in Chemical Biology, Sloan Kettering Institute, New York, NY 10065, USA.
| | - John F Gerecitano
- Lymphoma Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
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5
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Grkovski M, Goel R, Krebs S, Staton KD, Harding JJ, Mellinghoff IK, Humm JL, Dunphy MPS. Pharmacokinetic Assessment of 18F-(2 S,4 R)-4-Fluoroglutamine in Patients with Cancer. J Nucl Med 2019; 61:357-366. [PMID: 31601700 DOI: 10.2967/jnumed.119.229740] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/31/2019] [Indexed: 12/13/2022] Open
Abstract
18F-(2S,4R)-4-fluoroglutamine (18F-FGln) is an investigational PET radiotracer for imaging tumor glutamine flux and metabolism. The aim of this study was to investigate its pharmacokinetic properties in patients with cancer. Methods: Fifty lesions from 41 patients (21 men and 20 women, aged 54 ± 14 y) were analyzed. Thirty-minute dynamic PET scans were performed concurrently with a rapid intravenous bolus injection of 232 ± 82 MBq of 18F-FGln, followed by 2 static PET scans at 97 ± 14 and 190 ± 12 min after injection. Five patients also underwent a second 18F-FGln study 4-13 wk after initiation of therapy with glutaminase, dual TORC1/2, or programmed death-1 inhibitors. Blood samples were collected to determine plasma and metabolite fractions and to scale the image-derived input function. Regions of interest were manually drawn to calculate SUVs. Pharmacokinetic modeling with both reversible and irreversible 1- and 2-tissue-compartment models was performed to calculate the kinetic rate constants K 1, k 2, k 3, and k 4 The analysis was repeated with truncated 30-min dynamic datasets. Results: Intratumor 18F-FGln uptake patterns demonstrated substantial heterogeneity in different lesion types. In most lesions, the reversible 2-tissue-compartment model was chosen as the most appropriate according to the Akaike information criterion. K 1, a surrogate biomarker for 18F-FGln intracellular transport, was the kinetic rate constant that was most correlated both with SUV at 30 min (Spearman ρ = 0.71) and with SUV at 190 min (ρ = 0.51). Only K 1 was reproducible from truncated 30-min datasets (intraclass correlation coefficient, 0.96). k 3, a surrogate biomarker for glutaminolysis rate, was relatively low in about 50% of lesions. Treatment with glutaminase inhibitor CB-839 substantially reduced the glutaminolysis rates as measured by k 3 Conclusion: 18F-FGln dynamic PET is a sensitive tool for studying glutamine transport and metabolism in human malignancies. Analysis of dynamic data facilitates better understanding of 18F-FGln pharmacokinetics and may be necessary for response assessment to targeted therapies that impact intracellular glutamine pool size and tumor glutaminolysis rates.
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Affiliation(s)
- Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Reema Goel
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Simone Krebs
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kevin D Staton
- Radiochemistry and Molecular Imaging Probe Core Facility, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James J Harding
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Ingo K Mellinghoff
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - John L Humm
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
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Dunphy MPS, Harding JJ, Venneti S, Zhang H, Burnazi EM, Bromberg J, Omuro AM, Hsieh JJ, Mellinghoff IK, Staton K, Pressl C, Beattie BJ, Zanzonico PB, Gerecitano JF, Kelsen DP, Weber W, Lyashchenko SK, Kung HF, Lewis JS. In Vivo PET Assay of Tumor Glutamine Flux and Metabolism: In-Human Trial of 18F-(2S,4R)-4-Fluoroglutamine. Radiology 2018; 287:667-675. [PMID: 29388903 DOI: 10.1148/radiol.2017162610] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose To assess the clinical safety, pharmacokinetics, and tumor imaging characteristics of fluorine 18-(2S,4R)-4-fluoroglutamine (FGln), a glutamine analog radiologic imaging agent. Materials and Methods This study was approved by the institutional review board and conducted under a U.S. Food and Drug Administration-approved Investigational New Drug application in accordance with the Helsinki Declaration and the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Between January 2013 and October 2016, 25 adult patients with cancer received an intravenous bolus of FGln tracer (mean, 244 MBq ± 118, <100 μg) followed by positron emission tomography (PET) and blood radioassays. Patient data were summarized with descriptive statistics. FGln biodistribution and plasma amino acid levels in nonfasting patients (n = 13) were compared with those from patients who fasted at least 8 hours before injection (n = 12) by using nonparametric one-way analysis of variance with Bonferroni correction. Tumor FGln avidity versus fluorodeoxyglucose (FDG) avidity in patients with paired PET scans (n = 15) was evaluated with the Fisher exact test. P < .05 was considered indicative of a statistically significant difference. Results FGln PET depicted tumors of different cancer types (breast, pancreas, renal, neuroendocrine, lung, colon, lymphoma, bile duct, or glioma) in 17 of the 25 patients, predominantly clinically aggressive tumors with genetic mutations implicated in abnormal glutamine metabolism. Acute fasting had no significant effect on FGln biodistribution and plasma amino acid levels. FGln-avid tumors were uniformly FDG-avid but not vice versa (P = .07). Patients experienced no adverse effects. Conclusion Preliminary human FGln PET trial results provide clinical validation of abnormal glutamine metabolism as a potential tumor biomarker for targeted radiotracer imaging in several different cancer types. © RSNA, 2018 Online supplemental material is available for this article. Clinical trial registration no. NCT01697930.
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Affiliation(s)
- Mark P S Dunphy
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - James J Harding
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Sriram Venneti
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Hanwen Zhang
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Eva M Burnazi
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Jacqueline Bromberg
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Antonio M Omuro
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - James J Hsieh
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Ingo K Mellinghoff
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Kevin Staton
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Christina Pressl
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Bradley J Beattie
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Pat B Zanzonico
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - John F Gerecitano
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - David P Kelsen
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Wolfgang Weber
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Serge K Lyashchenko
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Hank F Kung
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
| | - Jason S Lewis
- From the Department of Radiology (M.P.S.D., W.W., J.S.L.), Department of Medicine (J.J.H., J.B., A.M.O., J.J.H., I.K.M., J.F.G., D.P.K.), Radiochemistry and Molecular Imaging Probe Core (H.Z., E.M.B., S.K.L., J.S.L.), and Department of Medical Physics (B.J.B., P.B.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room S113E, New York, NY 10065; Molecular Pharmacology and Chemistry Program, Sloan Kettering Institute, New York, NY (H.Z., K.S., J.S.L.); Department of Radiology, Weill-Cornell Medical College, New York, NY (M.P.S.D., W.W., J.S.L.); Laboratory of Neural Systems, the Rockefeller University, New York, NY (C.P.); Department of Pathology, University of Michigan, Ann Arbor, Mich (S.V.); and Departments of Radiology and Pharmacology, University of Pennsylvania, Philadelphia, Pa (H.F.K.)
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Rodina A, Wang T, Yan P, Gomes ED, Dunphy MPS, Pillarsetty N, Koren J, Gerecitano JF, Taldone T, Zong H, Caldas-Lopes E, Alpaugh M, Corben A, Riolo M, Beattie B, Pressl C, Peter RI, Xu C, Trondl R, Patel HJ, Shimizu F, Bolaender A, Yang C, Panchal P, Farooq MF, Kishinevsky S, Modi S, Lin O, Chu F, Patil S, Erdjument-Bromage H, Zanzonico P, Hudis C, Studer L, Roboz GJ, Cesarman E, Cerchietti L, Levine R, Melnick A, Larson SM, Lewis JS, Guzman ML, Chiosis G. The epichaperome is an integrated chaperome network that facilitates tumour survival. Nature 2016; 538:397-401. [PMID: 27706135 DOI: 10.1038/nature19807] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 09/02/2016] [Indexed: 01/01/2023]
Abstract
Transient, multi-protein complexes are important facilitators of cellular functions. This includes the chaperome, an abundant protein family comprising chaperones, co-chaperones, adaptors, and folding enzymes-dynamic complexes of which regulate cellular homeostasis together with the protein degradation machinery. Numerous studies have addressed the role of chaperome members in isolation, yet little is known about their relationships regarding how they interact and function together in malignancy. As function is probably highly dependent on endogenous conditions found in native tumours, chaperomes have resisted investigation, mainly due to the limitations of methods needed to disrupt or engineer the cellular environment to facilitate analysis. Such limitations have led to a bottleneck in our understanding of chaperome-related disease biology and in the development of chaperome-targeted cancer treatment. Here we examined the chaperome complexes in a large set of tumour specimens. The methods used maintained the endogenous native state of tumours and we exploited this to investigate the molecular characteristics and composition of the chaperome in cancer, the molecular factors that drive chaperome networks to crosstalk in tumours, the distinguishing factors of the chaperome in tumours sensitive to pharmacologic inhibition, and the characteristics of tumours that may benefit from chaperome therapy. We find that under conditions of stress, such as malignant transformation fuelled by MYC, the chaperome becomes biochemically 'rewired' to form a network of stable, survival-facilitating, high-molecular-weight complexes. The chaperones heat shock protein 90 (HSP90) and heat shock cognate protein 70 (HSC70) are nucleating sites for these physically and functionally integrated complexes. The results indicate that these tightly integrated chaperome units, here termed the epichaperome, can function as a network to enhance cellular survival, irrespective of tissue of origin or genetic background. The epichaperome, present in over half of all cancers tested, has implications for diagnostics and also provides potential vulnerability as a target for drug intervention.
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Affiliation(s)
- Anna Rodina
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Tai Wang
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Pengrong Yan
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Erica DaGama Gomes
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Mark P S Dunphy
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | | | - John Koren
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - John F Gerecitano
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Tony Taldone
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Hongliang Zong
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Eloisi Caldas-Lopes
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Mary Alpaugh
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Adriana Corben
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Matthew Riolo
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Brad Beattie
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Christina Pressl
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Radu I Peter
- Department of Mathematics, Technical University of Cluj-Napoca, Cluj-Napoca 400114, Romania
| | - Chao Xu
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Robert Trondl
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Hardik J Patel
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Fumiko Shimizu
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Alexander Bolaender
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Chenghua Yang
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Palak Panchal
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Mohammad F Farooq
- Molecular, Cellular &Biomedical Sciences, University of New Hampshire, Durham, New Hampshire 03824, USA
| | - Sarah Kishinevsky
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA
| | - Shanu Modi
- Breast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Oscar Lin
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Feixia Chu
- Molecular, Cellular &Biomedical Sciences, University of New Hampshire, Durham, New Hampshire 03824, USA
| | - Sujata Patil
- Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Hediye Erdjument-Bromage
- Microchemistry and Proteomics Core, Molecular Biology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Pat Zanzonico
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Clifford Hudis
- Breast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Lorenz Studer
- Developmental Biology Program, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Gail J Roboz
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Ethel Cesarman
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Leandro Cerchietti
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Ross Levine
- Human Oncology and Pathogenesis Program, Sloan Kettering Institute, New York, New York 10065, USA
| | - Ari Melnick
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Steven M Larson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Monica L Guzman
- Haematology and Medical Oncology, Department of Medicine, Weill Cornell Medical College, New York, New York 10065, USA
| | - Gabriela Chiosis
- Program in Chemical Biology, Sloan Kettering Institute, New York, New York 10065, USA.,Breast Cancer Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
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Nitadori JI, Bograd AJ, Morales EA, Rizk NP, Dunphy MPS, Sima CS, Rusch VW, Adusumilli PS. Preoperative consolidation-to-tumor ratio and SUVmax stratify the risk of recurrence in patients undergoing limited resection for lung adenocarcinoma ≤2 cm. Ann Surg Oncol 2013; 20:4282-8. [PMID: 23955584 PMCID: PMC4373319 DOI: 10.1245/s10434-013-3212-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE Limited resection is an increasingly utilized option for treatment of clinical stage IA lung adenocarcinoma (ADC) ≤2 cm (T1aN0M0), yet there are no validated predictive factors for postoperative recurrence. We investigated the prognostic value of preoperative consolidation/tumor (C/T) ratio [on computed tomography (CT) scan] and maximum standardized uptake value (SUVmax) on (18)F-fluorodeoxyglucose-positron emission tomography (PET) scan. METHODS We retrospectively reviewed 962 consecutive patients who underwent limited resection for lung cancer at Memorial Sloan-Kettering between 2000 and 2008. Patients with available CT and PET scans were included in the analysis. C/T ratio of 25 % (in accordance with the Japan Clinical Oncology Group 0201) and SUVmax of 2.2 (cohort median) were used as cutoffs. Cumulative incidence of recurrence (CIR) was assessed. RESULTS A total of 181 patients met the study inclusion criteria. Patients with a low C/T ratio (n = 15) had a significantly lower 5-year recurrence rate compared with patients with a high C/T ratio (n = 166) (5-year CIR, 0 vs. 33 %; p = 0.015), as did patients with low SUVmax (n = 86) compared with patients with high SUVmax (n = 95; 5-year CIR, 18 vs. 40 %; p = 0.002). Furthermore, within the high C/T ratio group, SUVmax further stratified risk of recurrence [5-year CIR, 22 % (low) vs. 40 % (high); p = 0.018]. CONCLUSIONS With the expected increase in diagnoses of small lung ADC as a result of more widespread use of CT screening, C/T ratio and SUVmax are widely available markers that can be used to stratify the risk of recurrence among cT1aN0M0 patients after limited resection.
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Affiliation(s)
- Jun-Ichi Nitadori
- Division of Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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9
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Kadota K, Colovos C, Suzuki K, Rizk NP, Dunphy MPS, Zabor EC, Sima CS, Yoshizawa A, Travis WD, Rusch VW, Adusumilli PS. FDG-PET SUVmax combined with IASLC/ATS/ERS histologic classification improves the prognostic stratification of patients with stage I lung adenocarcinoma. Ann Surg Oncol 2012; 19:3598-605. [PMID: 22644511 PMCID: PMC4049004 DOI: 10.1245/s10434-012-2414-3] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND We investigated the association between the newly proposed International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification and (18)F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET), and whether the combination of these radiologic and pathologic factors can further prognostically stratify patients with stage I lung adenocarcinoma. METHODS We retrospectively evaluated 222 patients with pathologic stage I lung adenocarcinoma who underwent FDG-PET scanning before undergoing surgical resection between 1999 and 2005. Patients were classified by histologic grade according to the IASLC/ATS/ERS classification (low, intermediate, or high grade) and by maximum standard uptake value (SUVmax) (low <3.0, high ≥3.0). The cumulative incidence of recurrence (CIR) was used to estimate recurrence probabilities. RESULTS Patients with high-grade histology had higher risk of recurrence (5-year CIR, 29% [n = 25]) than those with intermediate-grade (13% [n = 181]) or low-grade (11% [n = 16]) histology (p = 0.046). High SUVmax was associated with high-grade histology (p < 0.001) and with increased risk of recurrence compared to low SUVmax (5-year CIR, 21% [n = 113] vs. 8% [n = 109]; p = 0.013). Among patients with intermediate-grade histology, those with high SUVmax had higher risk of recurrence than those with low SUVmax (5-year CIR, 19% [n = 87] vs. 7% [n = 94]; p = 0.033). SUVmax was associated with recurrence even after adjusting for pathologic stage (p = 0.037). CONCLUSIONS SUVmax on FDG-PET correlates with the IASLC/ATS/ERS classification and can be used to stratify patients with intermediate-grade histology, the predominant histologic subtype, into two prognostic subsets.
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Affiliation(s)
- Kyuichi Kadota
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Christos Colovos
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Kei Suzuki
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Nabil P. Rizk
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Mark P. S. Dunphy
- Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Emily C. Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Camelia S. Sima
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Akihiko Yoshizawa
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
| | - William D. Travis
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Valerie W. Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Prasad S. Adusumilli
- Thoracic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
- Center for Cell Engineering, Memorial Sloan-Kettering Cancer Center, New York, NY
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Dunphy MPS, Zanzonico P, Veach D, Somwar R, Pillarsetty N, Lewis J, Larson S. Dosimetry of 18F-labeled tyrosine kinase inhibitor SKI-249380, a dasatinib-tracer for PET imaging. Mol Imaging Biol 2012; 14:25-31. [PMID: 21161687 PMCID: PMC3113455 DOI: 10.1007/s11307-010-0462-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To obtain estimates of human normal-organ radiation doses of ¹⁸F-SKI-249380, as a prerequisite step towards first-in-human trial. ¹⁸F-SKI-249380 is a first-of-its-kind PET tracer for imaging the in vivo pharmacokinetics of dasatinib, an investigational targeted therapy for solid malignancies. PROCEDURES Isoflurane-anesthetized mice received tracer dose via tail vein. Organ time-integrated activity coefficients, fractional urinary and hepatobiliary excretion, and total-body clearance kinetics were derived from PET data, with allometric extrapolation to the Standard Man anatomic model and normal-organ-absorbed dose calculations using OLINDA/EXM software. RESULTS The human effective dose was 0.031 mSv/MBq. The critical organ was the upper large intestine, with a dose equivalent of 0.25 mSv/MBq. A 190-MBq administered activity of ¹⁸F-SKI-249380 is thus predicted to expose an adult human to radiation doses generally comparable to those of routinely used diagnostic radiopharmaceuticals. CONCLUSIONS Animal-based human dose estimates support first-in-human testing of ¹⁸F-SKI-249380.
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Affiliation(s)
- Mark P S Dunphy
- Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Room H-214B, Box 77, New York, NY 10065, USA.
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Dunphy MPS, Entenberg D, Toledo-Crow R, Larson SM. In vivo microcartography and subcellular imaging of tumor angiogenesis: a novel platform for translational angiogenesis research. Microvasc Res 2009; 78:51-6. [PMID: 19362098 PMCID: PMC2739383 DOI: 10.1016/j.mvr.2009.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 03/12/2009] [Accepted: 03/25/2009] [Indexed: 01/09/2023]
Abstract
PURPOSE To eliminate the variable of tumor heterogeneity from a novel in vivo model of tumor angiogenesis. EXPERIMENTAL DESIGN We developed a method to navigate tumor neovasculature in a living tissue microenvironment, enabling relocation of a cell- or microregion-of-interest, for serial in vivo imaging. Orthotopic melanoma was grown, in immunocompetent Tie2GFP mice. Intravital multiphoton fluorescence and confocal reflectance imaging was performed, on a custom microscope with motorized stage and coordinate navigation software. A point within a Tie2GFP+ microvessel was selected for relocation. Custom software predicted target coordinates based upon reference points (tissue-embedded polystyrene beads) and baseline target coordinates. Mice were removed from the stage to make previously-obtained target coordinates invalid in subsequent imaging. RESULTS Coordinate predictions always relocated target points, in vivo, to within 10-200 microm (within a single 40x field-of-view). The model system provided a virtual living histology of tumor neovascularization and microenvironment, with subcellular spatial resolution and hemodynamic information. CONCLUSIONS The navigation procedure, termed in vivo microcartography, permits control of tissue heterogeneity, as a variable. Tie2 may be the best reporter gene identified, to-date, for intravital microscopy of tumor angiogenesis. This novel model system should strengthen intravital microscopy in its historical role as a vital tool in oncology, angiogenesis research, and angiotherapeutic drug development.
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Affiliation(s)
- Mark P S Dunphy
- Sloan Kettering Institute for Cancer Research, 418 East 68th Street, New York, NY 10065, USA.
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Abstract
This review article discusses PET agents, other than (18)F-FDG, with the potential to monitor the response to therapy before, during, or after therapeutic intervention. This review deals primarily with non-(18)F-FDG PET tracers that are in the final stages of preclinical development or in the early stages of clinical application for monitoring the therapeutic response. Four sections related to the nature of the tracers are included: radiotracers of DNA synthesis, such as the 2 most promising agents, the thymidine analogs 3'-(18)F-fluoro-3'-deoxythymidine and (18)F-1-(2'-deoxy-2'-fluoro-beta-d-arabinofuranosyl)thymine; agents for PET imaging of hypoxia within tumors, such as (60/62/64)Cu-labeled diacetyl-bis(N(4)-methylthiosemicarbazone) and (18)F-fluoromisonidazole; amino acids for PET imaging, including the most popular such agent, l-[methyl-(11)C]methionine; and agents for the imaging of tumor expression of androgen and estrogen receptors, such as 16beta-(18)F-fluoro-5alpha-dihydrotestosterone and 16alpha-(18)F-fluoro-17beta-estradiol, respectively.
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Affiliation(s)
- Mark P S Dunphy
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA
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Affiliation(s)
- Mark P S Dunphy
- Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA
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Dunphy MPS, Freiman A, Larson SM, Strauss HW. Association of vascular 18F-FDG uptake with vascular calcification. J Nucl Med 2005; 46:1278-84. [PMID: 16085583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
UNLABELLED Both calcification and FDG uptake have been advocated as indicators of atheroma. Atheromas calcify as cells in the lesion undergo apoptosis and necrosis during evolution of the lesion and at the end stage of the lesion. FDG concentrates in lesions due to the relatively dense cellularity in regions of inflammation of active atheromas. This investigation examines the geographic relationship of focal vascular (18)F-FDG uptake, as a marker of atherosclerotic inflammation, to arterial calcification detected by contemporaneous CT. METHODS We reviewed PET/CT images from 78 patients who were referred for tumor staging for the presence of vascular (18)F-FDG uptake and vascular calcification. Arterial wall (18)F-FDG accumulation greater than adjacent blood-pool activity was considered inflammation. Arterial attenuation of >130 Hounsfield units was considered calcification. Sites in the ascending and descending aorta, the carotid and iliac arteries, and the coronary territories were examined on the emission, CT, and fusion images on a point-by-point basis. When lesions were seen, we evaluated whether they were overlapping or discrete. RESULTS The (18)F-FDG arterial distribution was consistent with established atherosclerotic topography, with increased uptake in the thoracic aorta, at the carotid bifurcation, and in the proximal coronary vessels. Arteries typically displayed a patchwork of normal vessel, focal inflammation, or calcification; inflammation and calcification overlapped in <2% of cases. Arterial inflammation preceded calcification, in terms of mean patient age. Coronary inflammation was more prevalent in patients with more cardiovascular risk factors. CONCLUSION Vascular calcification and vascular metabolic activity rarely overlap, suggesting these findings represent different stages in the evolution of atheroma.
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Affiliation(s)
- Mark P S Dunphy
- Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
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