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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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Results of serial monitoring of tumor tHb and stO2 during bevacizumab treatment.A. Percentage change in tumor tHb on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab relative to the baseline level. There were no significant difference of the value between responders and non-responders during the time points. B. The mean value of stO2 at baseline (Day −1) and on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab. The value of nonresponders was significantly lower than that of responders on day 1, day 3, and day 6 (p<0.05).
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pone-0098715-g005: Results of serial monitoring of tumor tHb and stO2 during bevacizumab treatment.A. Percentage change in tumor tHb on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab relative to the baseline level. There were no significant difference of the value between responders and non-responders during the time points. B. The mean value of stO2 at baseline (Day −1) and on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab. The value of nonresponders was significantly lower than that of responders on day 1, day 3, and day 6 (p<0.05).

Mentions: Figure 5A shows the change in the mean tumor tHb levels from baseline during treatment. The mean tumor tHb level at baseline (mean, 60.5 µM±38.5 SD) was compared with those at day 1 (mean, 49.6 µM±26.3 SD, p = 0.5), day 3 (mean, 47.5 µM±32.3 SD, p = 0.5), day 6 (mean, 54.6 µM±41.9 SD, p = 0.7), day 8 (mean, 50.5 µM±30.9 SD, p = 0.6), and day 13 (mean, 58.8 µM±40.7 SD, p = 0.9). There were no significant difference of tumor tHb level between responders and nonresponders on each time point.


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)

Results of serial monitoring of tumor tHb and stO2 during bevacizumab treatment.A. Percentage change in tumor tHb on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab relative to the baseline level. There were no significant difference of the value between responders and non-responders during the time points. B. The mean value of stO2 at baseline (Day −1) and on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab. The value of nonresponders was significantly lower than that of responders on day 1, day 3, and day 6 (p<0.05).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0098715-g005: Results of serial monitoring of tumor tHb and stO2 during bevacizumab treatment.A. Percentage change in tumor tHb on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab relative to the baseline level. There were no significant difference of the value between responders and non-responders during the time points. B. The mean value of stO2 at baseline (Day −1) and on days 1, 3, 6, 8, and 13 after the initiation of bevacizumab. The value of nonresponders was significantly lower than that of responders on day 1, day 3, and day 6 (p<0.05).
Mentions: Figure 5A shows the change in the mean tumor tHb levels from baseline during treatment. The mean tumor tHb level at baseline (mean, 60.5 µM±38.5 SD) was compared with those at day 1 (mean, 49.6 µM±26.3 SD, p = 0.5), day 3 (mean, 47.5 µM±32.3 SD, p = 0.5), day 6 (mean, 54.6 µM±41.9 SD, p = 0.7), day 8 (mean, 50.5 µM±30.9 SD, p = 0.6), and day 13 (mean, 58.8 µM±40.7 SD, p = 0.9). There were no significant difference of tumor tHb level between responders and nonresponders on each time point.

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