230
- Baseline value of biomarker CYFRA 21-1. In advanced stage NSCLC, the initial
level of serum CYFRA appears to provide more prognostic information than
clinical stage. - Area under the curve (AUC) of the values of nucleosomes days on 1–8.
Anticancer Therapy Targeted Microbubbles to Tumors for Monitoring
Anticancer Therapy
New strategies to detect tumor angiogenesis and monitor response of tumor vascu-
lature to therapy are needed. Vascular Targeting Agent technology using contrast
ultrasound imaging with microbubbles targeted to tumor endothelium offers a non-
invasive method for monitoring and quantifying vascular effects of antitumor ther-
apy. The microbubbles are tiny lipid or albumin shells fi lled with an inert gas that
have a well-established safety record as contrast agents for ultrasound imaging
applications, and they are currently widely used in cardiovascular medicine.
Targeted microbubbles conjugated to MAbs were used to image and quantify vas-
cular effects of two different antitumor therapies in pancreatic tumor-bearing mice
treated with anti-vascular VEGF MAbs and/or gemcitabine (Korpanty et al. 2007 ).
Video intensity from targeted microbubbles correlated with the level of expression
of the target (CD105, VEGFR2, or the VEGF-VEGFR complex) and with microves-
sel density in tumors under antiangiogenic or cytotoxic therapy. It was concluded
that targeted microbubbles represent a novel and attractive tool for noninvasive,
vascular-targeted molecular imaging of tumor angiogenesis and for monitoring vas-
cular effects specifi c to antitumor therapy in vivo. This information could allow
oncologists to modify patient treatment regimens soon after starting therapy, so that
nonresponders could be switched to other therapies that might be more effective for
them. The clinical development of contrast agents is typically faster than for thera-
peutics, and clinical trials of this approach could be feasible within 12–18 months.
The potential of the approach is enhanced by the fact that the targeted microbubbles
are “read” using ultrasound technology, which is widely available in most physi-
cians’ offi ces and is minimally invasive, safe and cost-effective. The personalized
medicine made feasible by this approach has the potential to increase the effi cacy of
cancer regimens, reduce side effects from ineffective treatments and improve the
overall cost effectiveness of cancer therapy.
PET Imaging for Determining Response to Chemotherapy
Gemcitabine (2′,2′-difl uorodeoxycytidine, dFdC) and cytosine arabinoside (cytara-
bine, ara-C) represent a class of nucleoside analogs used in cancer chemotherapy.
Administered as prodrugs, dFdC and ara-C are transported across cell membranes
and are converted to cytotoxic derivatives through consecutive phosphorylation
10 Personalized Therapy of Cancer