PET Imaging in Head and Neck Cancer Patients to Monitor Treatment Response: A Future Role for EGFR-Targeted Imaging

  title={PET Imaging in Head and Neck Cancer Patients to Monitor Treatment Response: A Future Role for EGFR-Targeted Imaging},
  author={Laura K van Dijk and Otto C Boerman and Johannes H.A.M. Kaanders and Johan Bussink},
  journal={Clinical Cancer Research},
  pages={3602 - 3609}
Approximately 50,000 new cases of head and neck squamous cell carcinoma (HNSCC) are diagnosed worldwide each year and subsequently treated with surgery, chemotherapy, radiotherapy, and/or targeted therapy. The heterogeneity of the patient population in terms of treatment response drives the search for tumor-specific biomarkers. Imaging of biomarkers can reveal patient-specific responses to therapies and, if assessed early after the start of treatment, may allow adaptation of treatment regimens… 

Affibody-Based PET Imaging to Guide EGFR-Targeted Cancer Therapy in Head and Neck Squamous Cell Cancer Models

In vivo studies demonstrated that coinjecting 10 μg of nonlabeled molecules with 89Zr-deferoxamine-ZEGFR:03115 allows for clear tumor visualization 3 h after injection, and a strong correlation was observed between PET analysis, ex vivo estimates of tracer concentration, and receptor expression in tumor tissues.

Molecular Imaging in Head and Neck Squamous Cell Carcinoma Patients

Developing of EGFR imaging with fluorescence and address preclinical imaging results in HNSCC models for other molecular targets, including integrin αvβ3 are addressed.

CD44v6-Targeted Imaging of Head and Neck Squamous Cell Carcinoma: Antibody-Based Approaches

It is concluded that the current evidence points to CD44v6 imaging being a promising approach for providing more specific and sensitive diagnostic tools, leading to customized treatment decisions and functional diagnosis.

Multimodal Imaging of Head and Neck Squamous Cell Carcinoma.

The complex, multidisciplinary approach to the treatment of advanced HNSCC requires multimodal imaging for adequate treatment planning and follow up, and new radiotracers and evaluation methods are expected to alter both imaging and treatment recommendations in the years to come.

Immuno-PET imaging based radioimmunotherapy in head and neck squamous cell carcinoma model

Results suggest that a diagnostic and therapeutic convergence radiopharmaceutical, 64Cu-/177Lu-PCTA-cetuximab has the potential of target selection using immuno-PET imaging and targeted therapy by RIT in EGFR expressing cetUXimab-resistant HNSCC tumors.

Epidermal growth factor receptor imaging in human head and neck cancer xenografts

Preclinical studies have shown that radioresistant tumors had a higher tracer uptake after irradiation, probably due to upregulation of membranous EGFR, thereby increasing target availability possibly as a compensation mechanism.

Targeted molecular imaging of head and neck squamous cell carcinoma: a window into precision medicine

By visualizing tumor biomarkers at cellular and molecular levels in vivo, targeted molecular imaging can be used to identify specific genetic and metabolic aberrations, thereby accelerating personalized treatment development for HNSCC patients.

PET and SPECT Imaging of the EGFR Family (RTK Class I) in Oncology

Among these, engineered scaffold proteins and single domain antibodies show highly encouraging results in clinical studies marking a noticeable trend towards the use of smaller sized agents for HER imaging.

Monitoring early response to chemoradiotherapy with 18F-FMISO dynamic PET in head and neck cancer

Pharmacokinetic modeling of FMISO dynamic PET reveals a more detailed characterization of the tumor microenvironment and assessment of response to chemoradiotherapy in HNC patients than a single static image does.

Clinical update on head and neck cancer: molecular biology and ongoing challenges

This update aims to build on the earlier 2014 review by bringing up to date the understanding of the molecular biology of HNSCCs and provide insights into areas of ongoing research and perspectives for the future.



PET-CT for response assessment and treatment adaptation in head and neck cancer.

Early Response Monitoring with 18F-FDG PET and Cetuximab-F(ab′)2-SPECT After Radiotherapy of Human Head and Neck Squamous Cell Carcinomas in a Mouse Model

EGFR accessibility can be visualized with 111In-cetuximab-F(ab′)2 SPECT before and after radiotherapy, implying that the tracer can be used to measure irradiation-induced changes of EGFR expression and can monitor the compensatory response of tumors to radiotherapy.

Radiolabeled Cetuximab Conjugates for EGFR Targeted Cancer Diagnostics and Therapy †

An overview of the preclinical studies that have been performed with radiolabeled cetuximab for imaging and/or treatment of different tumor models suggests the integration of diagnosis, treatment and monitoring as a theranostic approach appears to be a promising strategy for improvement of individualized cancer treatment.

Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer.

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  • Medicine, Physics
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Imaging of Epidermal Growth Factor Receptor Expression in Head and Neck Cancer with SPECT/CT and 111In-Labeled Cetuximab-F(ab′)2

The 111In-cetuximab-F(ab′)2 tracer to image EGFR targeting in vivo displays higher tumor-to-blood ratios early after injection than 111 in an HNSCC model, making it more suitable for EGFR visualization and potentially for selecting patients for treatment with EGFR inhibitors.

Tumour response and safety of cetuximab in a window pre-operative study in patients with squamous cell carcinoma of the head and neck.

Short-course pre-operative administration of cetuximab is safe and shows a high rate of (18)FDG-PET response, which was correlated with residual tumour cellularity suggesting that ( 18)FDg-PET deserves further investigation as a potential early marker of cETuximAB activity in SCCHN.

18F-FLT PET/CT for Early Response Monitoring and Dose Escalation in Oropharyngeal Tumors

18F-FLT is a promising PET tracer for imaging tumor cell proliferation in head and neck carcinomas and definition of tumor subvolumes with high proliferative activity and dose escalation to these regions are technically feasible.

18F-FLT PET During Radiotherapy or Chemoradiotherapy in Head and Neck Squamous Cell Carcinoma Is an Early Predictor of Outcome

In head and neck cancer, a change in 18F-FLT uptake early during radiotherapy or chemoradiotherapy is a strong indicator for long-term outcome and may aid in personalized patient management by steering treatment modifications during an early phase of therapy.

Early prediction of survival following induction chemotherapy with DCF (docetaxel, cisplatin, 5-fluorouracil) using FDG PET/CT imaging in patients with locally advanced head and neck squamous cell carcinoma

Early therapeutic response demonstrated on FDG PET/CT after two cycles of induction chemotherapy with DCF in patients with inoperable stage III/IV HNSCC seems to be a predictive factor for event-free survival.