Oncology Research and Global Imaging Group, Novartis Institutes for Biomedical Research, Basel, Switzerland.
Clin Cancer Res. 2010 Jan 1;16(1):212-25. doi: 10.1158/1078-0432.CCR-09-0686. Epub 2009 Dec 15.
Identification of a generic response biomarker by comparison of chemotherapeutics with different action mechanisms on several noninvasive biomarkers in experimental tumor models.
The spin-lattice relaxation time of water protons (T(1)) was quantified using an inversion recovery-TrueFISP magnetic resonance imaging method in eight different experimental tumor models before and after treatment at several different time points with five different chemotherapeutics. Effects on T(1) were compared with other minimally invasive biomarkers including vascular parameters, apparent diffusion coefficient, and interstitial fluid pressure, and were correlated with efficacy at the endpoint and histologic parameters.
In all cases, successful chemotherapy significantly lowered tumor T(1) compared with vehicle and the fractional change in T(1) (DeltaT(1)) correlated with the eventual change in tumor size (range: r(2) = 0.21, P < 0.05 to r(2) = 0.73, P < 0.0001), except for models specifically resistant to that drug. In RIF-1 tumors, interstitial fluid pressure was decreased, but apparent diffusion coefficient and permeability increased in response to the microtubule stabilizer patupilone and 5-fluorouracil. Although DeltaT(1) was small (maximum of -20%), the variability was very low (5%) compared with other magnetic resonance imaging methods (24-48%). Analyses ex vivo showed unchanged necrosis, increased apoptosis, and decreased %Ki67 and total choline, but only Ki67 and choline correlated with DeltaT(1). Correlation of Ki67 and DeltaT(1) were observed in other models using patupilone, paclitaxel, a VEGF-R inhibitor, and the mammalian target of rapamycin inhibitor everolimus.
These results suggest that a decrease in tumor T(1) reflects hypocellularity and is a generic marker of response. The speed and robustness of the method should facilitate its use in clinical trials.
通过比较几种作用机制不同的化疗药物在多个非侵入性生物标志物上对实验性肿瘤模型的影响,确定一种通用的反应生物标志物。
在使用五种不同化疗药物进行多次不同时间点的治疗前后,使用反转恢复-TrueFISP 磁共振成像方法对八个不同实验肿瘤模型中的水质子自旋晶格弛豫时间(T1)进行定量,并将其与其他微创生物标志物(包括血管参数、表观扩散系数和细胞外液压力)进行比较,并与终点疗效和组织学参数相关联。
在所有情况下,与载体相比,成功的化疗均显著降低了肿瘤 T1(DeltaT1),并且 DeltaT1 的变化与肿瘤大小的最终变化相关(范围:r² = 0.21,P < 0.05 至 r² = 0.73,P < 0.0001),除了对特定药物具有抗性的模型。在 RIF-1 肿瘤中,微管稳定剂 patupilone 和 5-氟尿嘧啶会导致细胞外液压力降低,但表观扩散系数和通透性增加。尽管 DeltaT1 的变化很小(最大为-20%),但与其他磁共振成像方法(24-48%)相比,其变异性非常低(5%)。离体分析显示,细胞坏死不变,细胞凋亡增加,Ki67 和总胆碱减少,但只有 Ki67 和胆碱与 DeltaT1 相关。在使用 patupilone、紫杉醇、VEGF-R 抑制剂和哺乳动物雷帕霉素靶蛋白抑制剂 everolimus 的其他模型中也观察到了 Ki67 和 DeltaT1 的相关性。
这些结果表明,肿瘤 T1 的降低反映了细胞减少,是反应的通用标志物。该方法的速度和稳健性应有助于其在临床试验中的应用。