title: Recommendations for measurement of tumour vascularity with positron emission tomography in early phase clinical trials.
abstract: The evaluation of drug pharmacodynamics and early tumour response are integral to current clinical trials of novel cancer therapeutics to explain or predict long term clinical benefit or to confirm dose selection. Tumour vascularity assessment by positron emission tomography could be viewed as a generic pharmacodynamic endpoint or tool for monitoring response to treatment. This review discusses methods for semi-quantitative and quantitative assessment of tumour vascularity. The radioligands and radiotracers range from direct physiological functional tracers like [(15)O]-water to macromolecular probes targeting integrin receptors expressed on neovasculature. Finally we make recommendations on ways to incorporate such measurements of tumour vascularity into early clinical trials of novel therapeutics.                         Key Points                      • [                         (                            15                         )                         O]-water is the gold standard for blood flow/tissue perfusion with PET                      • In some instances dynamic [                         (                            18                         )                         F]-FDG uptake may be used to estimate perfusion                      • Radiopharmaceuticals that target integrins are now being evaluated for measuring tumour vascularity.
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, MRC Cyclotron Building, Hammersmith Hospital Campus, London, W12 0NN, UK. eric.aboagye@imperial.ac.uk
authors.forename: Eric O
authors.initials: EO
authors.lastname: Aboagye
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Gilbert
authors.forename: Ian N
authors.initials: IN
authors.lastname: Fleming
authors.forename: Ambros J
authors.initials: AJ
authors.lastname: Beer
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Cunningham
authors.forename: Paul K
authors.initials: PK
authors.lastname: Marsden
authors.forename: Dimitris
authors.initials: D
authors.lastname: Visvikis
authors.forename: Antony D
authors.initials: AD
authors.lastname: Gee
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Groves
authors.forename: Laura M
authors.initials: LM
authors.lastname: Kenny
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Cook
authors.forename: Paul E
authors.initials: PE
authors.lastname: Kinahan
authors.forename: Melvyn
authors.initials: M
authors.lastname: Myers
authors.forename: Larry
authors.initials: L
authors.lastname: Clarke
mesh_terms: D002986:Clinical Trials as Topic / Q000592:standards*; D005060:Europe; D006801:Humans; D009369:Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D009656:North America; D049268:Positron-Emission Tomography / Q000592:standards*; D017410:Practice Guidelines as Topic; D019275:Radiopharmaceuticals / Q000592:standards*; D012015:Reference Standards
chemical_list: D019275:Radiopharmaceuticals