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Optical imaging for monitoring tumor oxygenation response after initiation of single-agent bevacizumab followed by cytotoxic chemotherapy in breast cancer patients.

Ueda S, Kuji I, Shigekawa T, Takeuchi H, Sano H, Hirokawa E, Shimada H, Suzuki H, Oda M, Osaki A, Saeki T - PLoS ONE (2014)

Bottom Line: The nonresponders had lower baseline stO2 levels compared with adjacent breast tissue stO2 levels along with a pattern of steadily low stO2 levels during the observation window.On the other hand, the responders appeared to sustain high stO2 levels with temporal fluctuation.Tumor stO2 level could be a predictor of an additional benefit of bevacizumab over that provided by paclitaxel.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.

ABSTRACT

Purpose: Optical imaging techniques for measuring tissue hemoglobin concentration have been recently accepted as a way to assess tumor vascularity and oxygenation. We investigated the correlation between early optical response to single-agent bevacizumab and treatment outcome.

Methods: Seven patients with advanced or metastatic breast cancer were treated with single-agent bevacizumab followed by addition of weekly paclitaxel. Optical imaging of patient's breasts was performed to measure tumor total hemoglobin concentration (tHb) and oxygen saturation (stO2) at baseline and on days 1, 3, 6, 8, and 13 after the first infusion of bevacizumab. To assess early metabolic response, 2-deoxy-2-(18F)-fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT), 18F-fluoromisonidazole (FMISO)-PET/CT, and magnetic resonance imaging were performed at baseline and after two cycles of the regimen.

Results: Seven patients were grouped as responders (n = 4) and nonresponders (n = 3) on the basis of metabolic response measured by FDG-PET/CT. The responders showed remarkable tumor shrinkage and low accumulations of FMISO tracer relative to those of the nonresponders at the completion of two cycles of chemotherapy. Tumors of both groups showed remarkable attenuation of mean tHb as early as day 1 after therapy initiation. The nonresponders had lower baseline stO2 levels compared with adjacent breast tissue stO2 levels along with a pattern of steadily low stO2 levels during the observation window. On the other hand, the responders appeared to sustain high stO2 levels with temporal fluctuation.

Conclusions: Low tumor stO2 level after single-agent bevacizumab treatment was characteristic of the nonresponders. Tumor stO2 level could be a predictor of an additional benefit of bevacizumab over that provided by paclitaxel.

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Related in: MedlinePlus

Baseline maps of breast tHb and stO2.Three dimensional reconstruction mapping of baseline tHb (A) and stO2 (B) of tumor-bearing breast and contralateral normal breast. Tumor-bearing breast map shows a 6×6-cm measurement area that included the tumor located at the center and surrounding normal tissues at the margins. Contralateral normal breast map includes a 4×4-cm measurement area corresponding a mirror image location.
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pone-0098715-g003: Baseline maps of breast tHb and stO2.Three dimensional reconstruction mapping of baseline tHb (A) and stO2 (B) of tumor-bearing breast and contralateral normal breast. Tumor-bearing breast map shows a 6×6-cm measurement area that included the tumor located at the center and surrounding normal tissues at the margins. Contralateral normal breast map includes a 4×4-cm measurement area corresponding a mirror image location.

Mentions: Figure 3A and B showed three dimensional reconstruction mapping of tHb and stO2 levels of tumor-bearing breast and contralateral normal breast. All patients had a hotspot corresponding to tumor lesion and significantly higher tHb of tumor-bearing breast (mean, 60.5 µM±38.5 SD) compared with that of contralateral normal breast (mean, 15.2 µM±5.1 SD, p = 0.009). Responding tumors (mean, 37.2%±9.5 SD) had significantly lower level of tHb compared to nonresponding tumors (mean, 91.6%±42.1 SD, p = 0.04). In contrast, for stO2 maps, there was no difference between tumor (mean, 67.3%±9.3 SD) and normal tissue (mean, 67.3%±5.1 SD, p = 0.9). Responding tumors appeared an elevation of stO2 level corresponding to tumor lesion and surrounding normal tissue, while nonresponding tumors showed a dip of stO2 level compared to surrounding normal tissue.


Optical imaging for monitoring tumor oxygenation response after initiation of single-agent bevacizumab followed by cytotoxic chemotherapy in breast cancer patients.

Ueda S, Kuji I, Shigekawa T, Takeuchi H, Sano H, Hirokawa E, Shimada H, Suzuki H, Oda M, Osaki A, Saeki T - PLoS ONE (2014)

Baseline maps of breast tHb and stO2.Three dimensional reconstruction mapping of baseline tHb (A) and stO2 (B) of tumor-bearing breast and contralateral normal breast. Tumor-bearing breast map shows a 6×6-cm measurement area that included the tumor located at the center and surrounding normal tissues at the margins. Contralateral normal breast map includes a 4×4-cm measurement area corresponding a mirror image location.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048242&req=5

pone-0098715-g003: Baseline maps of breast tHb and stO2.Three dimensional reconstruction mapping of baseline tHb (A) and stO2 (B) of tumor-bearing breast and contralateral normal breast. Tumor-bearing breast map shows a 6×6-cm measurement area that included the tumor located at the center and surrounding normal tissues at the margins. Contralateral normal breast map includes a 4×4-cm measurement area corresponding a mirror image location.
Mentions: Figure 3A and B showed three dimensional reconstruction mapping of tHb and stO2 levels of tumor-bearing breast and contralateral normal breast. All patients had a hotspot corresponding to tumor lesion and significantly higher tHb of tumor-bearing breast (mean, 60.5 µM±38.5 SD) compared with that of contralateral normal breast (mean, 15.2 µM±5.1 SD, p = 0.009). Responding tumors (mean, 37.2%±9.5 SD) had significantly lower level of tHb compared to nonresponding tumors (mean, 91.6%±42.1 SD, p = 0.04). In contrast, for stO2 maps, there was no difference between tumor (mean, 67.3%±9.3 SD) and normal tissue (mean, 67.3%±5.1 SD, p = 0.9). Responding tumors appeared an elevation of stO2 level corresponding to tumor lesion and surrounding normal tissue, while nonresponding tumors showed a dip of stO2 level compared to surrounding normal tissue.

Bottom Line: The nonresponders had lower baseline stO2 levels compared with adjacent breast tissue stO2 levels along with a pattern of steadily low stO2 levels during the observation window.On the other hand, the responders appeared to sustain high stO2 levels with temporal fluctuation.Tumor stO2 level could be a predictor of an additional benefit of bevacizumab over that provided by paclitaxel.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan.

ABSTRACT

Purpose: Optical imaging techniques for measuring tissue hemoglobin concentration have been recently accepted as a way to assess tumor vascularity and oxygenation. We investigated the correlation between early optical response to single-agent bevacizumab and treatment outcome.

Methods: Seven patients with advanced or metastatic breast cancer were treated with single-agent bevacizumab followed by addition of weekly paclitaxel. Optical imaging of patient's breasts was performed to measure tumor total hemoglobin concentration (tHb) and oxygen saturation (stO2) at baseline and on days 1, 3, 6, 8, and 13 after the first infusion of bevacizumab. To assess early metabolic response, 2-deoxy-2-(18F)-fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT), 18F-fluoromisonidazole (FMISO)-PET/CT, and magnetic resonance imaging were performed at baseline and after two cycles of the regimen.

Results: Seven patients were grouped as responders (n = 4) and nonresponders (n = 3) on the basis of metabolic response measured by FDG-PET/CT. The responders showed remarkable tumor shrinkage and low accumulations of FMISO tracer relative to those of the nonresponders at the completion of two cycles of chemotherapy. Tumors of both groups showed remarkable attenuation of mean tHb as early as day 1 after therapy initiation. The nonresponders had lower baseline stO2 levels compared with adjacent breast tissue stO2 levels along with a pattern of steadily low stO2 levels during the observation window. On the other hand, the responders appeared to sustain high stO2 levels with temporal fluctuation.

Conclusions: Low tumor stO2 level after single-agent bevacizumab treatment was characteristic of the nonresponders. Tumor stO2 level could be a predictor of an additional benefit of bevacizumab over that provided by paclitaxel.

Show MeSH
Related in: MedlinePlus