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Using image-guided nuclear intervention to cut cancer cells off at the pass

por John W. Mitchell, Senior Correspondent | September 20, 2016
Molecular Imaging Women's Health
The rapidly developing field of nuclear medicine tracers — or probes — to noninvasively study cancer cells in real time during treatment got an "exciting" boost this week. A research team from Massachusetts General Hospital in Boston and Memorial Sloan Kettering in New York City published findings in the Journal of Nuclear Medicine that may help doctors respond more accurately with supplemental cancer treatments.

"Oftentimes, targeted cancer therapies are combined to kill tumors. One of the ways tumors sometimes avoid being killed is by responding to a therapy to overcome its effects," Umar Mahmood, M.D., Ph.D., a member of the research team, a professor of radiology and director of the Division of Precision Medicine at Harvard Medical School, told HCB News.

According to Mahmood, the nuclear medicine probes they have developed in combination with PET imaging can help determine the best way to overcome a specific tumor's effort to resist treatment.

"We can image some of the common ways this can happen with several important classes of treatment, and then use that information to give the tumors the most effective second (therapy) punch," said Mahmood.

He likened breast cancer treatment to a chess game with the tumor.

"We have made a move by blocking a signaling node," explained Mahmood. "The cancer cell has responded by increasing a cell surface receptor to overcome this block. Our imaging allows us to make an optimal move to specifically block the type of cell surface receptor the cell increased.”

This monitoring at the cell level is possible with the image-guided probe interventions, specific nuclear tracers that help image tumor biology under PET scans.

The specific clinical findings of the team's study show that imaging of cell surface receptor changes with PET probes specific to epidermal growth factor receptor 1 (EGFR) and human epidermal growth factor receptor 3 (HER3). This finding directly addresses an unmet need in cancer therapy decision-making, while avoiding the need for repeat biopsies.

Mahmood said the potential of their research is that a great number of specific cell processes can be imaged noninvasively. A patient benefits from real-time data to help their oncologists optimize their treatment on an individual basis, rather than relying on standing protocols.

He said the team next plans to apply their findings to prostate cancer and then lung cancer.

"It is an exciting time for image-guided interventions," said Mahmood.

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