Molecular Cancer Targets

Wester H Clin Cancer Res 2007;13:3470-3481

Strengths of PET in Oncology1. Improved Tumor Detection

Only PET shows malignant intra-thoracic LN

2. Therapy Response Evaluation

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3. Tumor CharacterisationPET Baseline

CT post R/

CT baseline

Hypoxia Tumour Vasculature

PET post R/

Wester, Clin Cancer Res 2007

4. Stromal Characterisation

Bergers & Benjamin, Nat Rev Cancer 2003Carroll & Ashcroft , Exp Rev Mol Med, 2005

Characterisation of Cancer Hallmarks

Hanahan & Weinberg,

Cell 2000

Wester H Clin Cancer Res 2007

αVβ6 - 5nm affinity ligand

Deroose et al., 2010, to be submitted

Hausner et al.,Cancer Res 2009

Bauwens et al., 2009, abstract Interreg

Apoptosis Imaging

ApoptosisNo Apoptosis

Imaging Angiogenesis

Growth Receptor Imaging

Dijkers et al, JNM 2009:

Her2/neu

Proliferation Imaging

Imaging TGF-β signalling

Kang et al, PNAS 2005

Imaging Tissue invasion

Normal Blockage

Imaging Metastasis

Deroose et al., JNM 2007 Hanahan and Weinberg, Cell 2000

Novel PET Tracers for Cancer Diagnosis

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CT: Normal

PET: Malignant Lymph Node

FDG-PET /CT: Current State of the art

BUT …

FDG is not tumor specific

Some tumors do not accumulate FDG

Need for assessement of non-cytoreductive therapies

Better Cancer Staging with FDG-PET/CT

Evaluation of Novel 68Ga-Labeled Receptor Ligand PET/CT to Detect Ovarian Cancer

http://www.enzolifesciences.com/

Folate Receptor (FR)

Fisher et al, JNM 2008

FR Scintigraphy 68Ga-FR Ligand

• First in man

• Dosimetry• 30 patients• Correlation

with post-op histology

Malignant LNCT: Normal

CT PET PET/CT

Malignant LN

Evaluation of 11C-Choline PET/CT in Locally Advanced Prostate Cancer

PET and Therapy Response Assessement

FDG-PET /CT: Current State of the art in lymphoma

Therapy Response Evaluation with FDG-PET/CT

Baseline Post R/

Residual MassCured

PET CT

Baseline

Post R/

BUT …

FDG is not tumor specific

Some tumors do not accumulate FDG

Response without complete remission in solid tumors

Need for assessement of non-cytoreductive therapies

Assessement of 90Y-DOTATOC Peptide Receptor Radiation Therapy with 68GA-DOTATOC PET/CT

Baseline Post R/SS Receptor in NET

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“Theranostic”

68Ga/90Y-DOTATOC

68G

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Assessement of Anti-Angiogenic Therapy with Angiogenesis PET

Deroose et al., 2010, to be submitted

Bevacuzimab

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Cancer Bloodvessel Ligand

Vessel PET

Multicenter Evaluation of PET as Response Predictor for Anti-EGFR Therapy in Metastatic Colorectal Cancer

Van Cutsem et al, NEJM 2009

Baseline

PE

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-Res

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Baseline 2 weeks

Survival 83 days

Survival 351 days

Prospective, multicenter trial to asses response to

Cetuximab with PET

5 PET centers

Tracer Production in Leuven

Ongoing Projects in Oncology

Diagnostic performance of Choline PET in Prostate Cancer

TR to Anti-angiogenic drugs in Colorectal Cancer

TRE – RT planning in Colorectal Cancer

TR to Anti-angiogenic Drugs in Colorectal Cancer

Novel PET Tracer for Ovarian Cancer

TRE to Medi551 in Non-Hodgkin Lymphoma (NHL)

TRE to Proteasome Inhibitors in NHL

TRE to Monoclonal Antibody in HL

TRE to Monoclonal Antibody in NHL

TRE to Anti-hormonal Therapy in Endometrial Cancer

TRE to Small Molecule Her2Neu TKI in Breast Cancer

TRE to Small Molecule Aurora Kinase Inhibitors in Sarcoma

TRE to Multitarget Small Molecule TKI in Sarcoma

TRE in NET after Peptide Receptor Radiation Therapy

TRE in Pediatric Hodgkin’s Lymphoma (HL)

Therapy Response Evaluation (TRE) in Lung Cancer (NSCLC)

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