García-Pérez Francisco Osvaldo, Medina-Ornelas Sevastian Salvador, Barron-Barron Feliciano, Arrieta-Rodriguez Oscar
Departament of Nuclear Medicine and Molecular Imaging, Instituto Nacional de Cancerología (INCan) Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México.
Functional Unit of Thoracic Oncology and Laboratory of Personalized Medicine, Instituto Nacional de Cancerología (INCan) Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, C.P. 14080, Ciudad de México, México.
Am J Nucl Med Mol Imaging. 2020 Jun 15;10(3):143-150. eCollection 2020.
Human copper transporter 1 (hCtr1) is the main transporter of copper which has been involved as an essential cofactor in biological processes and mechanisms of action for cisplatin and its analogues. Although expression of hCtr1 is present in all tissues that require copper, several studies have showed that levels of expression are highly variable between normal and neoplastic tissues. We evaluated the potential diagnostic of the CuCl-PET/CT in patients with wild type non-small cell lung cancer (NSCLC). Eleven patients were included. Baseline F-FDG-PET/CT and CuCl-PET/CT performed before to initiate treatment with platinum-based chemotherapy. F-FDG-PET/CT detected a total of 68 lesions in different corporal sites: lung (24), regional lymph node (30), distant non-bone metastases (17) and bone metastases (14). Of total, 73% demonstrated high focal uptake of CuCl-PET/CT: 36% in primary tumor and 27% in lymph-nodes metastases. The detection-rates (DRs) was lower with CuCl PET/CT compared to F-FDG-PET/CT, however, these was not statistically significant ( = 0.108). A complete match was found in 2 patients. All patients were treated with platinum-based chemotherapy. According to RECIST 1.1 and PERCIST 1.0 criteria, most patients with highest uptake CuCl-PET/CT presented partial response (mean 3 cycles) corroborated with F-FDG PET/CT. On the other hand, patients with very low uptake or faint uptake have progressive disease (3/16 patients). To our knowledge, this is the first study with CuCl-PET/CT in-human in patients with NSCLC chemo-naïve. Our results may represent that CuCl-PET/CT had a good ability for detect lesions. In addition, the CuCl uptake is based on the expression of Ctr1 transporters seeking to differentiate between those patients who may benefit from platinum-based therapy. More studies are necessary for confirm these findings.
人铜转运蛋白1（hCtr1）是铜的主要转运体，铜作为一种必需的辅助因子参与了顺铂及其类似物的生物学过程和作用机制。尽管hCtr1在所有需要铜的组织中均有表达，但多项研究表明，其在正常组织和肿瘤组织中的表达水平差异很大。我们评估了CuCl-PET/CT对野生型非小细胞肺癌（NSCLC）患者的潜在诊断价值。纳入了11例患者。在开始铂类化疗前进行了基线F-FDG-PET/CT和CuCl-PET/CT检查。F-FDG-PET/CT在不同身体部位共检测到68个病灶：肺（24个）、区域淋巴结（30个）、远处非骨转移（17个）和骨转移（14个）。其中，73%的病灶在CuCl-PET/CT上表现为高局灶性摄取：原发性肿瘤中为36%，淋巴结转移中为27%。与F-FDG-PET/CT相比，CuCl PET/CT的检出率（DRs）较低，然而，差异无统计学意义（P = 0.108）。在2例患者中发现完全匹配。所有患者均接受了铂类化疗。根据RECIST 1.1和PERCIST 1.0标准，大多数CuCl-PET/CT摄取最高的患者出现部分缓解（平均3个周期），F-FDG PET/CT也证实了这一点。另一方面，摄取极低或摄取微弱的患者出现疾病进展（16例患者中有3例）。据我们所知，这是第一项在初治NSCLC患者中进行的人体CuCl-PET/CT研究。我们的结果可能表明CuCl-PET/CT具有良好的病灶检测能力。此外，CuCl摄取基于Ctr1转运体的表达，旨在区分那些可能从铂类治疗中获益的患者。需要更多研究来证实这些发现。
