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PET Scans Might Allow Early Prediction of Response to Targeted Therapy of Thyroid Cancer

By MedImaging International staff writers
Posted on 16 Feb 2011

Positron emission tomography (PET) can image metabolic changes following treatment with the protein kinase inhibitor vandetanib, helping to define the therapy response or the effectiveness of the agent.

The study's findings were published in the February 2011 issue of the Journal of Nuclear Medicine. Currently being tested in clinical trials, vandetanib inhibits the function of the RET (rearranged-during-transfection protein) proto-oncogene and other protein kinases involved in the development and progression of cancer.

"For the most part, clinical trials have been measuring the effectiveness of vandetanib by changes in tumor size. Based on the activating effects of mutated RET and other protein kinases on numerous intracellular metabolic pathways, we hypothesized that PET imaging could play a role in the early evaluation of response to vandetanib,” said Martin A. Walter, MD, from the department of molecular and medical pharmacology, the University of California, Los Angeles (UCLA) David Geffen School of Medicine (Los Angeles, CA, USA) and lead author of the study.

The study evaluated the usefulness of metabolic imaging to determine response to vandetanib in three ways. First, medullary thyroid cancer cells were used to create an in vitro model. After cultivation, the cells were treated with vandetanib, and changes in the metabolic profile of the cells were successfully monitored by transcriptional profiling and by radiotracer uptake studies.

Using the same untreated cells, the researchers then created an in vivo model by injecting mice with the cancerous cells and treating them with vandetanib. Small animal PET/computed tomography (CT) imaging was performed and was found to reproduce the in vitro findings of metabolic activity after three days. Ultimately, a 43-year old patient with biopsy-proven metastasized medullary thyroid cancer was treated with vandetanib. PET scans taken at 12 and 24 weeks after treatment were able to detect metabolic response to vandetanib, consistent with the in vitro and in vivo samples.

"With the increasing number of available treatment options, careful patient selection is necessary to ensure targeted therapy is administered to those most likely to gain clinical benefit,” concluded Dr. Walter. "The identification of markers of treatment efficacy is a key factor for the success of these novel treatment approaches. Furthermore, relating in-vivo PET imaging metabolic data with transcriptional profiling data using cluster analysis is an innovative concept that allows much potential in the field of molecular imaging.”

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66 (39.100646972656): select jos_google_plus.link from jos_google_plus where cat=10

67 (40.054321289062): select jos_linkedin.link from jos_linkedin where cat=10

68 (50.067901611328): SELECT fid FROM jos_deeppockets WHERE id=294733431 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294733431 AND published='1' LIMIT 1

69 (35.04753112793): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (292.06275939941): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (254.15420532227): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (68.902969360352): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (87.02278137207): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (59.843063354492): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.140182495117): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (128.98445129395): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2602.1003723145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

105 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

106 (113.01040649414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (624.8950958252): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (970.84045410156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

109 (344.03800964355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

110 (!!!!! 1528.9783477783): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (708.81843566895): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 2810.001373291): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 1612.1864318848): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 1087.9039764404): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

115 (!!!!! 2372.9801177979): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

116 (528.81240844727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

117 (!!!!! 1926.1837005615): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

118 (!!!!! 2094.9840545654): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

119 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

120 (!!!!! 1079.0824890137): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

121 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

122 (372.88665771484): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 69867.134094238): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 3799.9153137207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733431 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733431 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 24055.957794189): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 4117.9656982422): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 1648.9028930664): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (518.0835723877): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (78.916549682617): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (61.03515625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (344.99168395996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (56.028366088867): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (56.982040405273): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (391.00646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (256.06155395508): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (77.009201049805): SELECT name FROM jos_deeppockets WHERE id=213

138 (34.093856811523): SELECT name FROM jos_deeppockets WHERE id=213

139 (643.01490783691): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (525.95138549805): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

142 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

143 (!!!!! 5174.8752593994): TRUNCATE TABLE jos_trademed_module

144 (526.90505981445): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (513.07678222656): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294733431 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (617.98095703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1471.996307373): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

149 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

150 (!!!!! 1094.8181152344): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

152 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

153 (34.093856811523): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294733431 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294733431 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (32.901763916016): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

155 (27.894973754883): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

156 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

158 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294733431 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294733431 AND published='1' LIMIT 1

159 (52.928924560547): select jos_twitters.link from jos_twitters where cat=10

160 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

161 (28.133392333984): select jos_google_plus.link from jos_google_plus where cat=10

162 (132.08389282227): select jos_linkedin.link from jos_linkedin where cat=10

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