Section Molecular Imaging

Matching the best drug to the right patient. Section

Matching the best drug to the right patient.

New and promising anti-cancer treatments have been developed over the past few years. Although these treatments have the potential to save lives, they are not successful for all patients. By employing Molecular Imaging we non-invasively visualize the tumour and tumour micro-environment to match the best treatment with the right patient.

Predicting if and how a patient will respond to a specific anti-cancer treatment is crucial in finding the correct patient-treatment match. This problem can be addressed by measurement of biomarkers in the patients. Classically, these are measured in blood or tumour tissue. However, blood only reflects the tumour status indirectly, and a small piece of tumour tissue does not reflect the disease status in the entire tumour nor in metastases, and both methods require withdrawal of patient material. With molecular imaging, we are able to visualise tumour characteristics non-invasively and in a whole body view.

Originally, molecular imaging technology such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) were employed to measure general tumour processes such as glucose consumption and DNA proliferation. Over the last years, the technology has developed rapidly and now allows for measurement of specific tumour processes by using specific tracers: labelled antibodies or drugs. Antibodies and drugs can be developed into tracers by labelling them with a radionuclide. These tracers are then tested in preclinical models, and if the preclinical results are promising, the tracer is produced to be used in the clinic. Cancer patients receive a tracer injection and are scanned on a PET scanner to measure the distribution of the tracer in healthy organs as well as in tumours and metastases.

This antibody-based approach greatly enlarges the possibilities to find targets of medication in all tumour lesions and exploit them to treat the cancer, as well as to investigate the biodistribution of drugs currently used in the clinic or are still in development phase. In the Molecular Imaging research theme of Medical Oncology we develop and test new antibody based approaches in our translational laboratory, and test the most promising targets in clinical trials.

Relevance

How our research benefits to society

There is a continuous development of new anti-cancer treatments with great promise. However, as many drugs are targeted and thus designed for a specific group of patients, the selection of the right patient has become an extra challenge. Molecular imaging has the ability predict treatment response based on an overview of the all lesions in a patient.

The UMCG Oncology PET imaging team has a long track record of conducting clinical trials which investigate if treatment response can be predicted. We continue investigating new targets and opportunities to maximally utilize all advantages molecular imaging has to offer.

By labelling specific antibodies against targetable proteins, molecular imaging can be used to discover the presence that particular protein in all tumour lesions. This technique can be used to select patients eligible for a specific drug, and prevent unnecessary treatment of patients who are not eligible.
With molecular imaging we can test the efficiency of drugs currently used in the clinic, as well as the potential of newly developed drugs. Labelling of the drug allows visualizing the biodistribution of that drug within the body, hereby allowing assessment whether the drug is able to find its target and whether it localised to other specific tissues, possibly predicting side-effects. By this application, molecular imaging aids in selection of the drug with the greatest promise in the clinic.
Over the recent years, antibodies targeting the immune system (immunotherapy) have greatly added to the range of anti-cancer therapies that medical oncologists can use. However, these anti-cancer approaches can only be successful when the antibody targets are present in the tumour or tumour micro-environment. We are developing methods of molecular imaging that can assess the presence of the correct targets to the antibodies in all lesions of the patient, so that we can ultimately predict treatment response in these patients.