Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
J Nucl Med. 2018 Jan;59(1):51-57. doi: 10.2967/jnumed.117.192286. Epub 2017 Aug 28.
The current standard for breast PET imaging is F-FDG. The heterogeneity of F-FDG uptake in breast cancer limits its utility, varying greatly among receptor status, histopathologic subtypes, and proliferation markers. F-FDG PET often exhibits nonspecific internalization and low specificity and sensitivity, especially with tumors smaller than 1 cm MYC is a protein involved in oncogenesis and is overexpressed in triple-negative breast cancer (TNBC). Increased surface expression of transferrin receptor (TfR) is a downstream event of MYC upregulation and has been validated as a clinically relevant target for molecular imaging. Transferrin labeled with Zr has successfully identified MYC status in many cancer subtypes preclinically and been shown to predict response and changes in oncogene status via treatment with small-molecule inhibitors that target MYC and PI3K signaling pathways. We hypothesized that Zr-transferrin PET will noninvasively detect MYC and TfR and improve upon the current standard of F-FDG PET for MYC-overexpressing TNBC. In this study, Zr-transferrin and F-FDG imaging were compared in preclinical models of TNBC. TNBC cells (MDA-MB-157, MDA-MB-231, and Hs578T) were treated with bromodomain-containing protein 4 (BRD4) inhibitors JQ1 and OTX015 (0.5-1 μM). Cell proliferation, gene expression, and protein expression were assayed to explore the effects of these inhibitors on MYC and TfR. Head-to-head comparison showed that Zr-transferrin targets TNBC tumors significantly better ( < 0.05-0.001) than F-FDG through PET imaging and biodistribution studies in MDA-MB-231 and MDA-MB-157 xenografts and a patient-derived xenograft model of TNBC. c-Myc and gene expression was decreased upon treatment with BRD4 inhibitors and small interfering RNA ( < 0.01-0.001 for responding cell lines), compared with vehicle treatment. MYC and TfR protein expression, along with receptor-mediated internalization of transferrin, was also significantly decreased upon drug treatment in MDA-MB-231 and MDA-MB-157 cells ( < 0.01-0.001). Zr-transferrin targets human TNBC primary tumors significantly better than F-FDG, as shown through PET imaging and biodistribution studies. Zr-transferrin is a useful tool to interrogate MYC via TfR-targeted PET imaging in TNBC.
目前,乳腺癌 PET 成像的标准示踪剂是 F-FDG。乳腺癌中 F-FDG 摄取的异质性限制了其应用,受体状态、组织病理学亚型和增殖标志物之间存在很大差异。F-FDG PET 常表现出非特异性内化和低特异性和敏感性,尤其是对于小于 1 cm 的肿瘤。MYC 是一种参与致癌的蛋白质,在三阴性乳腺癌(TNBC)中过表达。转铁蛋白受体(TfR)的表面表达增加是 MYC 上调的下游事件,已被验证为分子成像的临床相关靶点。Zr 标记的转铁蛋白在许多癌症亚型的临床前研究中成功确定了 MYC 状态,并通过使用针对 MYC 和 PI3K 信号通路的小分子抑制剂进行治疗,显示出可预测反应和癌基因状态的变化。我们假设 Zr-转铁蛋白 PET 将无创性地检测 MYC 和 TfR,并改善目前 MYC 过表达的 TNBC 的 F-FDG PET 标准。在这项研究中,Zr-转铁蛋白和 F-FDG 成像在 TNBC 的临床前模型中进行了比较。TNBC 细胞(MDA-MB-157、MDA-MB-231 和 Hs578T)用溴结构域蛋白 4(BRD4)抑制剂 JQ1 和 OTX015(0.5-1 μM)处理。通过细胞增殖、基因表达和蛋白质表达检测来探索这些抑制剂对 MYC 和 TfR 的影响。对头对头比较表明,Zr-转铁蛋白通过 PET 成像和 MDA-MB-231 和 MDA-MB-157 异种移植以及 TNBC 患者来源异种移植模型中的生物分布研究,比 F-FDG 更有效地靶向 TNBC 肿瘤(<0.05-0.001)。与载体处理相比,BRD4 抑制剂和小干扰 RNA(响应细胞系<0.01-0.001)处理后,c-Myc 和 基因表达降低。在 MDA-MB-231 和 MDA-MB-157 细胞中,药物治疗后,MYC 和 TfR 蛋白表达以及转铁蛋白受体介导的内化也显著降低(<0.01-0.001)。通过 PET 成像和生物分布研究,Zr-转铁蛋白比 F-FDG 更有效地靶向人类 TNBC 原发性肿瘤。Zr-转铁蛋白是一种通过 TfR 靶向 PET 成像研究 TNBC 中 MYC 的有用工具。