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Assessing responses to cancer therapy using molecular imaging
André A Neves1, Kevin M Brindle
1Department of Biochemistry, University of Cambridge, Cambridge CB2 1GA, UK.
Abstract:
Tumor responses to therapy in the clinic are still evaluated primarily from non-invasive imaging measurements of reductions in tumor size. This approach, however, lacks sensitivity and can only give a delayed indication of a positive response to treatment. Major advances in our understanding of the molecular mechanisms responsible for cancer, combined with new targeted clinical imaging technologies designed to detect the molecular correlates of disease progression and response to treatment, are set to revolutionize our approach to the detection and treatment of the disease. We describe here the imaging technologies available to image tumor cell proliferation and migration, metabolism, receptor and gene expression, apoptosis and tumor angiogenesis and vascular function, and show how measurements of these parameters can be used to give early indications of positive responses to treatment or to detect drug resistance and/or disease recurrence. Special emphasis has been placed on those applications that are already used in the clinic and those that are likely to translate into clinical application in the near future or whose use in preclinical studies is likely to facilitate translation of new treatments into the clinic.
Insights
Current tumor imaging relies on size reduction, which is insensitive and delayed. New molecular imaging technologies offer early detection of treatment response, drug resistance, and recurrence, revolutionizing cancer care.
Area of Science:
- Oncology
- Medical Imaging
- Molecular Biology
Background:
- Clinical evaluation of cancer therapy response primarily uses tumor size reduction via non-invasive imaging.
- This traditional method lacks sensitivity and provides only delayed indicators of treatment efficacy.
- Advances in molecular understanding and targeted imaging technologies are poised to transform cancer detection and treatment.
Purpose of the Study:
- To review current and emerging molecular imaging technologies for assessing tumor characteristics.
- To demonstrate how these technologies can provide early indications of treatment response or detect resistance and recurrence.
- To highlight clinically relevant applications and those nearing translation for improved cancer management.
Main Methods:
- Review of advanced imaging technologies targeting molecular aspects of cancer.
- Discussion of imaging modalities for proliferation, migration, metabolism, gene expression, apoptosis, angiogenesis, and vascular function.
- Emphasis on clinical and preclinical applications facilitating new treatment translation.
Main Results:
- Molecular imaging offers sensitive and early detection of treatment response compared to size-based methods.
- These technologies can identify drug resistance and predict disease recurrence.
- Specific applications are already in clinical use or have high potential for near-term translation.
Conclusions:
- Molecular imaging represents a paradigm shift in evaluating cancer treatment efficacy.
- Early detection of response and resistance through molecular imaging enhances personalized cancer therapy.
- Continued development and clinical integration of these technologies promise improved patient outcomes.
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