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Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2016

01-08-2016 | Original Article

RGD-K5 PET/CT in patients with advanced head and neck cancer treated with concurrent chemoradiotherapy: Results from a pilot study

Authors: Shih-Hsin Chen, Hung-Ming Wang, Chien-Yu Lin, Joseph Tung-Chieh Chang, Chia-Hsun Hsieh, Chun-Ta Liao, Chung-Jan Kang, Lan-Yan Yang, Tzu-Chen Yen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2016

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Abstract

Background/Aim

We prospectively investigated the potential usefulness of PET using a new tracer targeting integrin αvβ3 (termed RGD-K5) in patients with head and neck cancer (HNC) undergoing definitive concurrent chemoradiotherapy (CCRT).

Patients and Methods

Newly diagnosed patients with locally advanced HNC scheduled for definitive CCRT were eligible. RDG-K5 PET and FDG PET scans were performed at three different time points (baseline, 2 weeks, and 3 months post-treatment).

Results

Nine patients completed all of the three scans, whereas two patients withdrew after two scans only. Uptake of both RGD-K5 and FDG generally decreased following CCRT. However, the observed decrease did not differ significantly between complete responders and non-responders. At 3 months post-treatment, the uptake of both RGD-K5 and FDG at the main tumors was significantly lower in those who achieved complete responses than in those with residual tumors.

Conclusion

RGD-K5 PET has the potential to identify patients with incomplete responses to CCRT.
Literature
3.
go back to reference Fabricius EM, Wildner GP, Kruse-Boitschenko U, Hoffmeister B, Goodman SL, Raguse JD. Immunohistochemical analysis of integrins alphavbeta3, alphavbeta5 and alpha5beta1, and their ligands, fibrinogen, fibronectin, osteopontin and vitronectin, in frozen sections of human oral head and neck squamous cell carcinomas. Exp Ther Med. 2011;2(1):9–19. doi:10.3892/etm.2010.171.PubMed Fabricius EM, Wildner GP, Kruse-Boitschenko U, Hoffmeister B, Goodman SL, Raguse JD. Immunohistochemical analysis of integrins alphavbeta3, alphavbeta5 and alpha5beta1, and their ligands, fibrinogen, fibronectin, osteopontin and vitronectin, in frozen sections of human oral head and neck squamous cell carcinomas. Exp Ther Med. 2011;2(1):9–19. doi:10.​3892/​etm.​2010.​171.PubMed
4.
go back to reference Beer AJ, Haubner R, Sarbia M, Goebel M, Luderschmidt S, Grosu AL, et al. Positron emission tomography using [18F]Galacto-RGD identifies the level of integrin alpha(v)beta3 expression in man. Clin Cancer Res. 2006;12(13):3942–9. doi:10.1158/1078-0432.CCR-06-0266.CrossRefPubMed Beer AJ, Haubner R, Sarbia M, Goebel M, Luderschmidt S, Grosu AL, et al. Positron emission tomography using [18F]Galacto-RGD identifies the level of integrin alpha(v)beta3 expression in man. Clin Cancer Res. 2006;12(13):3942–9. doi:10.​1158/​1078-0432.​CCR-06-0266.CrossRefPubMed
5.
go back to reference Beer AJ, Grosu AL, Carlsen J, Kolk A, Sarbia M, Stangier I, et al. [18F]galacto-RGD positron emission tomography for imaging of alphavbeta3 expression on the neovasculature in patients with squamous cell carcinoma of the head and neck. Clin Cancer Res. 2007;13(22 Pt 1):6610–6. doi:10.1158/1078-0432.CCR-07-0528.CrossRefPubMed Beer AJ, Grosu AL, Carlsen J, Kolk A, Sarbia M, Stangier I, et al. [18F]galacto-RGD positron emission tomography for imaging of alphavbeta3 expression on the neovasculature in patients with squamous cell carcinoma of the head and neck. Clin Cancer Res. 2007;13(22 Pt 1):6610–6. doi:10.​1158/​1078-0432.​CCR-07-0528.CrossRefPubMed
8.
go back to reference Doss M, Kolb HC, Zhang JJ, Belanger MJ, Stubbs JB, Stabin MG, et al. Biodistribution and radiation dosimetry of the integrin marker 18F-RGD-K5 determined from whole-body PET/CT in monkeys and humans. J Nucl Med. 2012;53(5):787–95. doi:10.2967/jnumed.111.088955.CrossRefPubMed Doss M, Kolb HC, Zhang JJ, Belanger MJ, Stubbs JB, Stabin MG, et al. Biodistribution and radiation dosimetry of the integrin marker 18F-RGD-K5 determined from whole-body PET/CT in monkeys and humans. J Nucl Med. 2012;53(5):787–95. doi:10.​2967/​jnumed.​111.​088955.CrossRefPubMed
9.
go back to reference Wang HM, Hsu CL, Hsieh CH, Fan KH, Lin CY, Chang JT, et al. Concurrent chemoradiotherapy using cisplatin, tegafur, and leucovorin for advanced squamous cell carcinoma of the hypopharynx and oropharynx. Biomed J. 2014;37(3):133–40. doi:10.4103/2319-4170.117893.PubMed Wang HM, Hsu CL, Hsieh CH, Fan KH, Lin CY, Chang JT, et al. Concurrent chemoradiotherapy using cisplatin, tegafur, and leucovorin for advanced squamous cell carcinoma of the hypopharynx and oropharynx. Biomed J. 2014;37(3):133–40. doi:10.​4103/​2319-4170.​117893.PubMed
12.
14.
go back to reference Chuang JY, Chen PC, Tsao CW, Chang AC, Lein MY, Lin CC, et al. WISP-1 a novel angiogenic regulator of the CCN family promotes oral squamous cell carcinoma angiogenesis through VEGF-A expression. Oncotarget. 2015;6(6):4239–52.CrossRefPubMedPubMedCentral Chuang JY, Chen PC, Tsao CW, Chang AC, Lein MY, Lin CC, et al. WISP-1 a novel angiogenic regulator of the CCN family promotes oral squamous cell carcinoma angiogenesis through VEGF-A expression. Oncotarget. 2015;6(6):4239–52.CrossRefPubMedPubMedCentral
15.
go back to reference Abdollahi A, Griggs DW, Zieher H, Roth A, Lipson KE, Saffrich R, et al. Inhibition of alpha(v)beta3 integrin survival signaling enhances antiangiogenic and antitumor effects of radiotherapy. Clin Cancer Res. 2005;11(17):6270–9. doi:10.1158/1078-0432.CCR-04-1223.CrossRefPubMed Abdollahi A, Griggs DW, Zieher H, Roth A, Lipson KE, Saffrich R, et al. Inhibition of alpha(v)beta3 integrin survival signaling enhances antiangiogenic and antitumor effects of radiotherapy. Clin Cancer Res. 2005;11(17):6270–9. doi:10.​1158/​1078-0432.​CCR-04-1223.CrossRefPubMed
16.
go back to reference Liao CT, Fan KH, Lin CY, Wang HM, Huang SF, Chen IH, et al. Impact of a second FDG PET scan before adjuvant therapy for the early detection of residual/relapsing tumours in high-risk patients with oral cavity cancer and pathological extracapsular spread. Eur J Nucl Med Mol Imaging. 2012;39(6):944–55. doi:10.1007/s00259-012-2103-2.CrossRefPubMed Liao CT, Fan KH, Lin CY, Wang HM, Huang SF, Chen IH, et al. Impact of a second FDG PET scan before adjuvant therapy for the early detection of residual/relapsing tumours in high-risk patients with oral cavity cancer and pathological extracapsular spread. Eur J Nucl Med Mol Imaging. 2012;39(6):944–55. doi:10.​1007/​s00259-012-2103-2.CrossRefPubMed
17.
go back to reference Kang CJ, Lin CY, Yang LY, Ho TY, Lee LY, Fan KH, et al. Positive clinical impact of an additional PET/CT scan before adjuvant radiotherapy or concurrent chemoradiotherapy in patients with advanced oral cavity squamous cell carcinoma. J Nucl Med. 2015;56(1):22–30. doi:10.2967/jnumed.114.145300.CrossRefPubMed Kang CJ, Lin CY, Yang LY, Ho TY, Lee LY, Fan KH, et al. Positive clinical impact of an additional PET/CT scan before adjuvant radiotherapy or concurrent chemoradiotherapy in patients with advanced oral cavity squamous cell carcinoma. J Nucl Med. 2015;56(1):22–30. doi:10.​2967/​jnumed.​114.​145300.CrossRefPubMed
18.
go back to reference Prestwich RJ, Subesinghe M, Gilbert A, Chowdhury FU, Sen M, Scarsbrook AF. Delayed response assessment with FDG-PET-CT following (chemo) radiotherapy for locally advanced head and neck squamous cell carcinoma. Clin Radiol. 2012;67(10):966–75. doi:10.1016/j.crad.2012.02.016.CrossRefPubMed Prestwich RJ, Subesinghe M, Gilbert A, Chowdhury FU, Sen M, Scarsbrook AF. Delayed response assessment with FDG-PET-CT following (chemo) radiotherapy for locally advanced head and neck squamous cell carcinoma. Clin Radiol. 2012;67(10):966–75. doi:10.​1016/​j.​crad.​2012.​02.​016.CrossRefPubMed
21.
go back to reference Toustrup K, Sorensen BS, Nordsmark M, Busk M, Wiuf C, Alsner J, et al. Development of a hypoxia gene expression classifier with predictive impact for hypoxic modification of radiotherapy in head and neck cancer. Cancer Res. 2011;71(17):5923–31. doi:10.1158/0008-5472.CAN-11-1182.CrossRefPubMed Toustrup K, Sorensen BS, Nordsmark M, Busk M, Wiuf C, Alsner J, et al. Development of a hypoxia gene expression classifier with predictive impact for hypoxic modification of radiotherapy in head and neck cancer. Cancer Res. 2011;71(17):5923–31. doi:10.​1158/​0008-5472.​CAN-11-1182.CrossRefPubMed
23.
25.
go back to reference Moeller BJ, Cao Y, Li CY, Dewhirst MW. Radiation activates HIF-1 to regulate vascular radiosensitivity in tumors: role of reoxygenation, free radicals, and stress granules. Cancer Cell. 2004;5(5):429–41.CrossRefPubMed Moeller BJ, Cao Y, Li CY, Dewhirst MW. Radiation activates HIF-1 to regulate vascular radiosensitivity in tumors: role of reoxygenation, free radicals, and stress granules. Cancer Cell. 2004;5(5):429–41.CrossRefPubMed
30.
go back to reference Hainsworth JD, Spigel DR, Greco FA, Shipley DL, Peyton J, Rubin M, et al. Combined modality treatment with chemotherapy, radiation therapy, bevacizumab, and erlotinib in patients with locally advanced squamous carcinoma of the head and neck: a phase II trial of the Sarah Cannon oncology research consortium. Cancer J. 2011;17(5):267–72. doi:10.1097/PPO.0b013e3182329791.CrossRefPubMed Hainsworth JD, Spigel DR, Greco FA, Shipley DL, Peyton J, Rubin M, et al. Combined modality treatment with chemotherapy, radiation therapy, bevacizumab, and erlotinib in patients with locally advanced squamous carcinoma of the head and neck: a phase II trial of the Sarah Cannon oncology research consortium. Cancer J. 2011;17(5):267–72. doi:10.​1097/​PPO.​0b013e3182329791​.CrossRefPubMed
31.
go back to reference Yoo DS, Kirkpatrick JP, Craciunescu O, Broadwater G, Peterson BL, Carroll MD, et al. Prospective trial of synchronous bevacizumab, erlotinib, and concurrent chemoradiation in locally advanced head and neck cancer. Clin Cancer Res. 2012;18(5):1404–14. doi:10.1158/1078-0432.CCR-11-1982.CrossRefPubMed Yoo DS, Kirkpatrick JP, Craciunescu O, Broadwater G, Peterson BL, Carroll MD, et al. Prospective trial of synchronous bevacizumab, erlotinib, and concurrent chemoradiation in locally advanced head and neck cancer. Clin Cancer Res. 2012;18(5):1404–14. doi:10.​1158/​1078-0432.​CCR-11-1982.CrossRefPubMed
32.
go back to reference Argiris A, Kotsakis AP, Hoang T, Worden FP, Savvides P, Gibson MK, et al. Cetuximab and bevacizumab: preclinical data and phase II trial in recurrent or metastatic squamous cell carcinoma of the head and neck. Ann Oncol. 2013;24(1):220–5. doi:10.1093/annonc/mds245.CrossRefPubMed Argiris A, Kotsakis AP, Hoang T, Worden FP, Savvides P, Gibson MK, et al. Cetuximab and bevacizumab: preclinical data and phase II trial in recurrent or metastatic squamous cell carcinoma of the head and neck. Ann Oncol. 2013;24(1):220–5. doi:10.​1093/​annonc/​mds245.CrossRefPubMed
33.
go back to reference Fury MG, Lee NY, Sherman E, Lisa D, Kelly K, Lipson B, et al. A phase 2 study of bevacizumab with cisplatin plus intensity-modulated radiation therapy for stage III/IVB head and neck squamous cell cancer. Cancer. 2012;118(20):5008–14. doi:10.1002/cncr.27498.CrossRefPubMed Fury MG, Lee NY, Sherman E, Lisa D, Kelly K, Lipson B, et al. A phase 2 study of bevacizumab with cisplatin plus intensity-modulated radiation therapy for stage III/IVB head and neck squamous cell cancer. Cancer. 2012;118(20):5008–14. doi:10.​1002/​cncr.​27498.CrossRefPubMed
34.
go back to reference Yao M, Galanopoulos N, Lavertu P, Fu P, Gibson M, Argiris A, et al. Phase II study of bevacizumab in combination with docetaxel and radiation in locally advanced squamous cell carcinoma of the head and neck. Head Neck. 2015;37(11):1665–71. doi:10.1002/hed.23813.CrossRefPubMed Yao M, Galanopoulos N, Lavertu P, Fu P, Gibson M, Argiris A, et al. Phase II study of bevacizumab in combination with docetaxel and radiation in locally advanced squamous cell carcinoma of the head and neck. Head Neck. 2015;37(11):1665–71. doi:10.​1002/​hed.​23813.CrossRefPubMed
35.
go back to reference Fury MG, Xiao H, Sherman EJ, Baxi S, Smith-Marrone S, Schupak K, et al. Phase II trial of bevacizumab + cetuximab + cisplatin with concurrent intensity-modulated radiation therapy for patients with stage III/IVB head and neck squamous cell carcinoma. Head Neck. 2015. doi:10.1002/hed.24041.PubMed Fury MG, Xiao H, Sherman EJ, Baxi S, Smith-Marrone S, Schupak K, et al. Phase II trial of bevacizumab + cetuximab + cisplatin with concurrent intensity-modulated radiation therapy for patients with stage III/IVB head and neck squamous cell carcinoma. Head Neck. 2015. doi:10.​1002/​hed.​24041.PubMed
36.
go back to reference Vermorken JB, Peyrade F, Krauss J, Mesia R, Remenar E, Gauler TC, et al. Cisplatin, 5-fluorouracil, and cetuximab (PFE) with or without cilengitide in recurrent/metastatic squamous cell carcinoma of the head and neck: results of the randomized phase I/II ADVANTAGE trial (phase II part). Ann Oncol. 2014;25(3):682–8. doi:10.1093/annonc/mdu003.CrossRefPubMedPubMedCentral Vermorken JB, Peyrade F, Krauss J, Mesia R, Remenar E, Gauler TC, et al. Cisplatin, 5-fluorouracil, and cetuximab (PFE) with or without cilengitide in recurrent/metastatic squamous cell carcinoma of the head and neck: results of the randomized phase I/II ADVANTAGE trial (phase II part). Ann Oncol. 2014;25(3):682–8. doi:10.​1093/​annonc/​mdu003.CrossRefPubMedPubMedCentral
Metadata
Title
RGD-K5 PET/CT in patients with advanced head and neck cancer treated with concurrent chemoradiotherapy: Results from a pilot study
Authors
Shih-Hsin Chen
Hung-Ming Wang
Chien-Yu Lin
Joseph Tung-Chieh Chang
Chia-Hsun Hsieh
Chun-Ta Liao
Chung-Jan Kang
Lan-Yan Yang
Tzu-Chen Yen
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-016-3345-1

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