title: PET imaging of zirconium-89 labelled cetuximab: A phase I trial in patients with head and neck and lung cancer.
abstract: PET imaging of cetuximab uptake may help selecting cancer patients with the highest chance of benefit. The aim of this phase I trial was to determine the safety of the tracer89Zr-cetuximab and to assess tumour uptake.
  
  
  
  Two dose schedules were used; two consecutive doses of 60MBq89Zr-cetuximab or a single dose of 120MBq, both preceded by 400mg/m2of unlabelled cetuximab. Toxicity (CTCAE 3.0) was scored twice weekly. PET-CT scans were acquired on days 4, 5 and 6 (step 1) or 5, 6, 7 (step 2). Because tumour uptake could not be assessed satisfactorily, a third step was added including EGFR overexpressing tumours.
  
  
  
  Nine patients were included (6 NSCLC; 3 HNC). No additional toxicity was associated with administration of89Zr-cetuximab compared to standard cetuximab. A tumour to blood ratio (TBR)>1 was observed in all but one patient, with a maximum of 4.56. TBR was not different between dose schedules. There was a trend for higher TBR at intervals>5days after injection.
  
  
  
  Both presented89Zr-cetuximab administration schedules are safe. The recommended dose for future trials is 60MBq, with a minimum time interval for scanning of 6days.
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands. Electronic address: Judith.vanloon@maastro.nl.
authors.forename: Judith
authors.initials: J
authors.lastname: van Loon
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Aniek J G
authors.initials: AJG
authors.lastname: Even
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands; Departments of Radiation Oncology and Radiology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
authors.forename: Hugo J W L
authors.initials: HJWL
authors.lastname: Aerts
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Öllers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Hoebers
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: van Elmpt
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Dubois
authors.affiliation: Department of Pulmonology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Anne-Marie C
authors.initials: AC
authors.lastname: Dingemans
authors.affiliation: Department of Medical Oncology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Roy I
authors.initials: RI
authors.lastname: Lalisang
authors.affiliation: Department of Nuclear Medicine, Maastricht University Medical Centre, The Netherlands.
authors.forename: Pascal
authors.initials: P
authors.lastname: Kempers
authors.affiliation: Department of Nuclear Medicine, Maastricht University Medical Centre, The Netherlands.
authors.forename: Boudewijn
authors.initials: B
authors.lastname: Brans
authors.affiliation: Department of Pathology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Véronique
authors.initials: V
authors.lastname: Winnepenninckx
authors.affiliation: Department of Pathology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Ernst-Jan
authors.initials: EJ
authors.lastname: Speel
authors.affiliation: Department of Pathology, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Thunnissen
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Smits
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Ronald
authors.initials: R
authors.lastname: Boellaard
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Danielle J
authors.initials: DJ
authors.lastname: Vugts
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands; Department of Radiation Oncology, University Hospital Leuven, KU Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lambin
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy*; D000068818:Cetuximab / Q000378:metabolism*; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D015040:Zirconium
chemical_list: D000970:Antineoplastic Agents; D015040:Zirconium; D066246:ErbB Receptors; D000068818:Cetuximab
keywords: (89)Zr-cetuximab; EGFR; Immuno-PET; Phase I trial