Molecular Imaging Center Antwerp, University of Antwerp, Universiteitsplein 1, B-2610 Wilrijk, Belgium.
Nuclear Medicine, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem, Belgium.
Mol Imaging. 2021 May 25;2021:5594514. doi: 10.1155/2021/5594514. eCollection 2021.
We investigated the potential use of [F]FDG PET as a response biomarker for PI3K pathway targeting therapies in two HER-2-overexpressing cancer models. . CD-1 nude mice were inoculated with HER-2-overexpressing JIMT1 (trastuzumab-resistant) or SKOV3 (trastuzumab-sensitive) human cancer cells. Animals were treated with trastuzumab, everolimus (mTOR inhibitor), PIK90 (PI3K inhibitor), saline, or combination therapy. [F]FDG scans were performed at baseline, two, and seven days after the start of the therapy. Tumors were delineated on CT images and relative tumor volumes (RTV) and maximum standardized uptake value (SUV) were calculated. Levels of pS6 and pAkt on protein tumor lysates were determined with ELISA. . In the SKOV3 xenografts, all treatment schedules resulted in a gradual decrease in RTV and delta SUV (SUV). For all treatments combined, SUV after 2 days was predictive for RTV after 7 days ( = 0.69, = 0.030). In JIMT1 tumors, monotherapy with everolimus or PIK90 resulted in a decrease in RTV (-30% ± 10% and -20% ± 20%, respectively) and SUV (-39% ± 36% and -42% ± 8%, respectively) after 7 days of treatment, but not earlier, while trastuzumab resulted in nonsignificant increases compared to control. Combination therapies resulted in RTV and SUV decrease already at day 2, except for trastuzumab+everolimus, where an early flare was observed. For all treatments combined, SUV after 2 days was predictive for RTV after 7 days ( = 0.48, = 0.028), but the correlation could be improved when combination with everolimus ( = 0.59, = 0.023) or trastuzumab ( = 0.69, = 0.015) was excluded. . Reduction in [F]FDG after 2 days correlated with tumor volume changes after 7 days of treatment and confirms the use of [F]FDG PET as an early response biomarker. Treatment response can however be underestimated in schedules containing trastuzumab or everolimus due to temporary increased [F]FDG uptake secondary to negative feedback loop and crosstalk between different pathways.
我们研究了 [F]FDG PET 作为两种过表达 HER-2 的癌症模型中 PI3K 通路靶向治疗的反应生物标志物的潜力。CD-1 裸鼠接种过表达 HER-2 的 JIMT1(曲妥珠单抗耐药)或 SKOV3(曲妥珠单抗敏感)人癌细胞。动物接受曲妥珠单抗、依维莫司(mTOR 抑制剂)、PIK90(PI3K 抑制剂)、生理盐水或联合治疗。在治疗开始后 2 天和 7 天进行 [F]FDG 扫描。在 CT 图像上勾画肿瘤,并计算相对肿瘤体积(RTV)和最大标准化摄取值(SUV)。用 ELISA 测定肿瘤蛋白裂解物中 pS6 和 pAkt 的水平。在 SKOV3 异种移植中,所有治疗方案均导致 RTV 和 delta SUV(SUV)逐渐下降。对于所有联合治疗,治疗后 2 天 SUV 可预测治疗后 7 天 RTV( = 0.69, = 0.030)。在 JIMT1 肿瘤中,依维莫司或 PIK90 的单药治疗在 7 天治疗后导致 RTV(-30%±10%和-20%±20%)和 SUV(-39%±36%和-42%±8%)下降,但早期未见变化,而曲妥珠单抗与对照相比无显著增加。联合治疗在第 2 天即可使 RTV 和 SUV 下降,除了曲妥珠单抗+依维莫司,其中观察到早期爆发。对于所有联合治疗,治疗后 2 天 SUV 可预测治疗后 7 天 RTV( = 0.48, = 0.028),但当排除与依维莫司( = 0.59, = 0.023)或曲妥珠单抗( = 0.69, = 0.015)联合治疗时,相关性可以得到改善。治疗后 2 天 [F]FDG 减少与治疗后 7 天的肿瘤体积变化相关,证实了 [F]FDG PET 作为早期反应生物标志物的应用。然而,由于不同途径之间的负反馈环和串扰导致的继发性 [F]FDG 摄取增加,在包含曲妥珠单抗或依维莫司的方案中,治疗反应可能会被低估。