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European Journal of Nuclear Medicine and Molecular Imaging

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01-10-2008 | Editorial

What oncologists need and require from nuclear medicine

Authors: M. A. Pantaleo, S. Fanti, M. Nannini, S. Boschi, C. Nanni, A. Maleddu, D. Rubello, G. Biasco

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2008

Excerpt

The detection of biological abnormalities of the solid tumours seems to be a crucial point in which targeted agents can be applied to cancer care. The methods to define a molecular profile of the tumour lesions are not very well-defined yet. Recent innovations on molecular basis, both the development of new technologies and the introduction to clinical practice of new biologic drugs, increase the benefits but also have some limitations (Table 1). The aim of this manuscript is to focus on the success and difficulties related to the application of new laboratory technologies and to the large use of biological drugs in medical oncology and also to discuss the potential research perspectives in collaboration between medical oncology and nuclear medicine to overcome some open clinical questions.

Table 1

Benefits and limitations of recent innovations on molecular basis in medical oncology

Tumour biological characterization	Molecular drugs development
Benefits	Benefits
High level technologies development:	Several new drugs available in clinical practice for:
Genomics	Advanced disease
DNA sequencing	Untreated and pre-treated patients
FISH	Alone or in combination with chemotherapy, radiotherapy, hormonal therapy
Real-time PCR	Adjuvant setting
Gene expression profiling	Neoadjuvant setting
SNPs array	Action on specific molecular targets o biological pathway
Proteomics	Mild toxicity
q-RT-PCR	Oral administration
Western blotting
ELISA
IHC
Comprehensive and more precise biological information
Limitations	Limitations
Small tissue specimens studies: no information of global tumour lesion’s background	Activity and efficacy
Biological tumour heterogeneity: difference between primary tumour and metastases	Results often controversial
Biological changes during the natural history of diseases especially in long survival and heavily pre-treated patients	Acquired resistance
Invasive, not repeatable and time-consuming procedures for the patient and physicians	Not well-known mechanism of action
	Not well-known optimal dose level
	Different combination schedules with chemotherapy
	Therapeutical response evaluation: combined morphological and functional criteria are not available
	Therapeutical response prediction: validated tumour markers in clinical practice are not available

…

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Title: What oncologists need and require from nuclear medicine
Authors: M. A. Pantaleo
S. Fanti
M. Nannini
S. Boschi
C. Nanni
A. Maleddu
D. Rubello
G. Biasco
Publication date: 01-10-2008
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2008
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-0825-y

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