VEGF-SPECT 联合¹¹¹In-贝伐珠单抗在 III/IV 期黑色素瘤患者中的应用。
VEGF-SPECT with ¹¹¹In-bevacizumab in stage III/IV melanoma patients.
机构信息
Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, 9700 RB Groningen, Netherlands.
出版信息
Eur J Cancer. 2011 Jul;47(10):1595-602. doi: 10.1016/j.ejca.2011.02.009. Epub 2011 Mar 21.
PURPOSE
A feasibility study was performed to investigate the presence of VEGF in melanoma lesions by VEGF-SPECT with (111)In-bevacizumab. In addition the effect of a single therapeutic bevacizumab dose on (111)In-bevacizumab uptake was compared with VEGF levels in resected melanoma lesions.
PATIENTS AND METHODS
Eligible were patients with stage III/IV melanoma who presented with nodal recurrent disease. VEGF-SPECT was performed after administration of 100 Mbq (111)In-bevacizumab (8 mg) at days 0, 2, 4 and 7 post injection. Tumour visualisation and quantification were compared with CT and FDG-PET. On day 7 a single dose of 7.5mg/kg bevacizumab was administered intravenously. On day 21, a second tracer dose (111)In-bevacizumab was administered and scans were obtained on days 21, 25 and 28. Metastases were surgically resected within 2 weeks after the last VEGF-SPECT scan and immunohistological (IHC) VEGF tumour expression was compared with (111)In-bevacizumab tumour uptake.
RESULTS
Nine patients were included. FDG-PET and CT detected both in total 12 nodal lesions which were all visualised by VEGF-SPECT. At baseline, (111)In-bevacizumab tumour uptake varied 3-fold between and 1.6 ± 0.1-fold within patients. After a therapeutic dose of bevacizumab there was a 21 ± 4% reduction in (111)In-bevacizumab uptake. The (111)In-bevacizumab tumour uptake in the second series positively correlated with the VEGF-A expression in the resected tumour lesions.
CONCLUSION
VEGF-SPECT could visualise all known melanoma lesions. A single dose of bevacizumab slightly lowered (111)In-bevacizumab uptake. Future studies should elucidate the role of VEGF-SPECT in the selection of patients and the individual dosing of bevacizumab treatment.
目的
通过 VEGF-SPECT 用（111）In-贝伐单抗研究黑色素瘤病变中 VEGF 的存在。此外，比较了单次治疗性贝伐单抗剂量对（111）In-贝伐单抗摄取的影响与切除的黑色素瘤病变中的 VEGF 水平。
方法
符合条件的是患有 III/IV 期黑色素瘤且出现淋巴结复发性疾病的患者。在注射后 0、2、4 和 7 天分别给予 100 MBq（111）In-贝伐单抗（8 mg）后进行 VEGF-SPECT。与 CT 和 FDG-PET 比较肿瘤的可视化和定量。第 7 天静脉内给予 7.5mg/kg 的单次贝伐单抗剂量。第 21 天，给予第二剂示踪剂（111）In-贝伐单抗，并在第 21、25 和 28 天进行扫描。在最后一次 VEGF-SPECT 扫描后 2 周内手术切除转移灶，并比较免疫组织化学（IHC）VEGF 肿瘤表达与（111）In-贝伐单抗肿瘤摄取。
结果
纳入了 9 名患者。FDG-PET 和 CT 总共检测到 12 个淋巴结病变，这些病变均通过 VEGF-SPECT 显示。在基线时，（111）In-贝伐单抗肿瘤摄取在患者之间变化了 3 倍，在患者内部变化了 1.6±0.1 倍。在贝伐单抗治疗剂量后，（111）In-贝伐单抗摄取减少了 21±4%。第二个系列中的（111）In-贝伐单抗肿瘤摄取与切除的肿瘤病变中的 VEGF-A 表达呈正相关。
结论
VEGF-SPECT 可以显示所有已知的黑色素瘤病变。单次贝伐单抗剂量可轻微降低（111）In-贝伐单抗摄取。未来的研究应该阐明 VEGF-SPECT 在选择患者和贝伐单抗治疗的个体化剂量中的作用。
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