Bensch Frederike, van Kruchten Michel, Lamberts Laetitia E, Schröder Carolien P, Hospers Geke A P, Brouwers Adrienne H, van Vugt Marcel A T M, de Vries Elisabeth G E
Department of Medical Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Eur J Pharmacol. 2013 Oct 5;717(1-3):2-11. doi: 10.1016/j.ejphar.2013.01.079. Epub 2013 Mar 30.
Currently, tumour response following drug treatment is based on measurement of anatomical size changes. This is often done according to Response Evaluation Criteria in Solid Tumours (RECIST) and is generally performed every 2-3 cycles. Bone metastases, being the most common site of distant metastases in breast cancer, are not measurable by RECIST. The standard response measurement provides no insight in changes of molecular characteristics. In the era of targeted medicine, knowledge of specific molecular tumour characteristics becomes more important. A potential way to assess this is by means of molecular imaging. Molecular imaging can visualise general tumour processes, such as glucose metabolism with (18)F-fluorodeoxyglucose ((18)F-FDG) and DNA synthesis with (18)F-fluorodeoxythymidine ((18)F-FLT). In addition, an increasing number of more specific targets, such as hormone receptors, growth factor receptors, and growth factors can be visualised. In the future molecular imaging may thus be of value for personalised treatment-selection by providing insight in the expression of these drug targets. Additionally, when molecular changes can be detected early during therapy, this may serve as early predictor of response. However, in order to define clinical utility of this approach results from (ongoing) clinical trials is required. In this review we summarise the potential role of molecular imaging of general tumour processes as well as hormone receptors, growth factor receptors, and tumour micro-environment for predicting and monitoring treatment response in breast cancer patients.
目前，药物治疗后的肿瘤反应是基于对解剖学大小变化的测量。这通常根据实体瘤疗效评价标准（RECIST）来进行，并且一般每2 - 3个周期进行一次。骨转移是乳腺癌远处转移最常见的部位，无法通过RECIST进行测量。标准的反应测量无法洞察分子特征的变化。在靶向治疗时代，了解特定的分子肿瘤特征变得更加重要。一种潜在的评估方法是通过分子成像。分子成像可以使一般的肿瘤过程可视化，例如用（18）F - 氟脱氧葡萄糖（（18）F - FDG）显示葡萄糖代谢，用（18）F - 氟脱氧胸苷（（18）F - FLT）显示DNA合成。此外，越来越多更特异的靶点，如激素受体、生长因子受体和生长因子也可以被可视化。因此，未来分子成像可能通过洞察这些药物靶点的表达，对个性化治疗选择具有价值。此外，当在治疗早期能够检测到分子变化时，这可能作为反应的早期预测指标。然而，为了确定这种方法的临床实用性，需要（正在进行的）临床试验的结果。在本综述中，我们总结了一般肿瘤过程以及激素受体、生长因子受体和肿瘤微环境的分子成像在预测和监测乳腺癌患者治疗反应方面的潜在作用。
