title: VEGF-SPECT with ¹¹¹In-bevacizumab in stage III/IV melanoma patients.
abstract: OBJECTIVE
  A feasibility study was performed to investigate the presence of VEGF in melanoma lesions by VEGF-SPECT with (111)In-bevacizumab. In addition the effect of a single therapeutic bevacizumab dose on (111)In-bevacizumab uptake was compared with VEGF levels in resected melanoma lesions.
  
  
  METHODS
  Eligible were patients with stage III/IV melanoma who presented with nodal recurrent disease. VEGF-SPECT was performed after administration of 100 Mbq (111)In-bevacizumab (8 mg) at days 0, 2, 4 and 7 post injection. Tumour visualisation and quantification were compared with CT and FDG-PET. On day 7 a single dose of 7.5mg/kg bevacizumab was administered intravenously. On day 21, a second tracer dose (111)In-bevacizumab was administered and scans were obtained on days 21, 25 and 28. Metastases were surgically resected within 2 weeks after the last VEGF-SPECT scan and immunohistological (IHC) VEGF tumour expression was compared with (111)In-bevacizumab tumour uptake.
  
  
  RESULTS
  Nine patients were included. FDG-PET and CT detected both in total 12 nodal lesions which were all visualised by VEGF-SPECT. At baseline, (111)In-bevacizumab tumour uptake varied 3-fold between and 1.6 ± 0.1-fold within patients. After a therapeutic dose of bevacizumab there was a 21 ± 4% reduction in (111)In-bevacizumab uptake. The (111)In-bevacizumab tumour uptake in the second series positively correlated with the VEGF-A expression in the resected tumour lesions.
  
  
  CONCLUSIONS
  VEGF-SPECT could visualise all known melanoma lesions. A single dose of bevacizumab slightly lowered (111)In-bevacizumab uptake. Future studies should elucidate the role of VEGF-SPECT in the selection of patients and the individual dosing of bevacizumab treatment.
authors.affiliation: Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, Postbus 30.001, 9700 RB Groningen, Netherlands.
authors.forename: Wouter B
authors.initials: WB
authors.lastname: Nagengast
authors.forename: Marjolijn N Lub-de
authors.initials: MN
authors.lastname: Hooge
authors.forename: Esther M E
authors.initials: EM
authors.lastname: van Straten
authors.forename: Schelto
authors.initials: S
authors.lastname: Kruijff
authors.forename: Adrienne H
authors.initials: AH
authors.lastname: Brouwers
authors.forename: Wilfred F A
authors.initials: WF
authors.lastname: den Dunnen
authors.forename: Johan R
authors.initials: JR
authors.lastname: de Jong
authors.forename: Harry
authors.initials: H
authors.lastname: Hollema
authors.forename: Rudi A
authors.initials: RA
authors.lastname: Dierckx
authors.forename: Nanno H
authors.initials: NH
authors.lastname: Mulder
authors.forename: Elisabeth G E
authors.initials: EG
authors.lastname: de Vries
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: Geke A P
authors.initials: GA
authors.lastname: Hospers
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry / Q000379:methods; D007205:Indium Radioisotopes / Q000737:chemistry; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D007205:Indium Radioisotopes; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab