Imaging hormone receptors in metastatic breast cancer patients

Clasina Marieke Venema

Imaging hormone receptors in metastatic breast cancer patients

Vertaalde titel van de bijdrage: Visualiseren van hormoon receptoren in gemetastaseerde borstkanker patiënten

Clasina Marieke Venema

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De expressie van oestrogeen receptoren, bepaald op borstkanker weefsel, is een belangrijke prognostische en voorspellende biomarker voor patiënten met borstkanker, en belangrijk voor het maken van behandelkeuzes. Het verkrijgen van weefsel van uitzaaiingen is geadviseerd omdat er verschil kan bestaan in tumoreigenschappen. Dit is niet altijd mogelijk, waardoor het onduidelijk is of er sprake is van heterogeniteit binnen een patiënt. Middels PET scans is het mogelijk om deze oestrogeen receptor te visualiseren in het gehele lichaam. Het UMCG heeft hierin veel ervaring met de zoekstof 18F-fluoroestradiol (FES).
In dit proefschrift worden aanbevelingen gedaan over het gebruik en interpretatie van deze FES-PET scans. Zo kan eerdere bestraling effect hebben op de beoordeling van de FES-PET. Ook hebben we een pilot-studie gedaan waarbij middels de FES-PET uitzaaiingen kunnen worden aangetoond die minder waarschijnlijk reageren op de combinatiebehandeling letrozol en palbociclib.
Naast de oestrogeen receptor speelt de androgeen receptor een rol in borstkanker, die wordt beschreven. We tonen aan dat androgeen receptor te visualiseren is met 18F-fluorodihydrotestosterone (FDHT) PET in borstkanker patiënten. Ook het effect van een receptor blokker kan worden gevisualiseerd.
Voor implementatie van deze nieuwe technieken in de kliniek zijn er aanvullende stappen nodig. We vatten de route van preklinisch naar klinische studies met PET tracers samen en mogelijke oplossingen voor implementatie.

Vertaalde titel van de bijdrage	Visualiseren van hormoon receptoren in gemetastaseerde borstkanker patiënten
Originele taal-2	English
Kwalificatie	Doctor of Philosophy
Toekennende instantie	Rijksuniversiteit Groningen
Begeleider(s)/adviseur	Hospers, Geke, Supervisor Schröder, Carolien, Co-supervisor de Vries, Erik, Co-supervisor Glaudemans, Andor, Co-supervisor
Datum van toekenning	9-mei-2018
Plaats van publicatie	[Groningen]
Uitgever	Rijksuniversiteit Groningen
Gedrukte ISBN's	978-94-028-0983-1
Status	Published - 2018

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Title and contentsFinal publisher's version, 224 KB
Chapter 1Final publisher's version, 190 KB
Chapter 2Final publisher's version, 591 KB
Chapter 3Final publisher's version, 484 KB
Chapter 4Final publisher's version, 882 KB
Chapter 5Final publisher's version, 1 MB
Chapter 6Final publisher's version, 2,62 MB
Chapter 7Final publisher's version, 967 KB
Chapter 8Final publisher's version, 951 KB
Chapter 9Final publisher's version, 392 KB
Chapter 10Final publisher's version, 222 KB
Chapter 11Final publisher's version, 167 KB
AppendicesFinal publisher's version, 121 KB
Complete thesisFinal publisher's version, 6,48 MB
PropositionsFinal publisher's version, 68,3 KB

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title = "Imaging hormone receptors in metastatic breast cancer patients",

abstract = "The expression of estrogen receptors (ER), determined in biopsies via immunohistochemistry, is a well-established predictive and prognostic biomarker in breast cancer. Biopsies of metastases are however not always feasible in a patient, as the lesion may be unsafe to biopsy. If one lesion is biopsied, heterogeneity of tumor characteristics amongst lesions throughout the body is still unknown. In vivo imaging of hormone receptors has the potential to guide clinical decision making. The UMCG has extensive experience in PET imaging of ER with the tracer 18F-fluoroestradiol (FES). In this thesis recommendations on the use and interpretation of FES-PET scans for breast cancer patients are described. For instance we show how previous radiation therapy affects FES PET results. And in a clinical pilot study we show that the FES-PET can identify metastases that are less likely to respond to the combination of letrozole plus palbociclib.The search for new biomarkers and drug targets continues, and as such the androgen receptor (AR) is of interest. The role of this receptor in breast cancer is reviewed in this thesis. We show that the AR on metastases can be visualized throughout the body by 18F-fluorodihydrotestosterone (FDHT) PET in breast cancer patients and the effect of an AR-blocker can also be visualized. Prior to further implementation of these novel imaging techniques in routine clinical practice, additional steps are needed. We summarize the route of PET tracers from pre-clinical to first-in-human molecular imaging studies, and the potential steps to implement more PET tracers into clinical practice.",

author = "Venema, {Clasina Marieke}",

year = "2018",

language = "English",

isbn = "978-94-028-0983-1",

publisher = "Rijksuniversiteit Groningen",

school = "University of Groningen",

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TY - BOOK

T1 - Imaging hormone receptors in metastatic breast cancer patients

AU - Venema, Clasina Marieke

PY - 2018

Y1 - 2018

N2 - The expression of estrogen receptors (ER), determined in biopsies via immunohistochemistry, is a well-established predictive and prognostic biomarker in breast cancer. Biopsies of metastases are however not always feasible in a patient, as the lesion may be unsafe to biopsy. If one lesion is biopsied, heterogeneity of tumor characteristics amongst lesions throughout the body is still unknown. In vivo imaging of hormone receptors has the potential to guide clinical decision making. The UMCG has extensive experience in PET imaging of ER with the tracer 18F-fluoroestradiol (FES). In this thesis recommendations on the use and interpretation of FES-PET scans for breast cancer patients are described. For instance we show how previous radiation therapy affects FES PET results. And in a clinical pilot study we show that the FES-PET can identify metastases that are less likely to respond to the combination of letrozole plus palbociclib.The search for new biomarkers and drug targets continues, and as such the androgen receptor (AR) is of interest. The role of this receptor in breast cancer is reviewed in this thesis. We show that the AR on metastases can be visualized throughout the body by 18F-fluorodihydrotestosterone (FDHT) PET in breast cancer patients and the effect of an AR-blocker can also be visualized. Prior to further implementation of these novel imaging techniques in routine clinical practice, additional steps are needed. We summarize the route of PET tracers from pre-clinical to first-in-human molecular imaging studies, and the potential steps to implement more PET tracers into clinical practice.

AB - The expression of estrogen receptors (ER), determined in biopsies via immunohistochemistry, is a well-established predictive and prognostic biomarker in breast cancer. Biopsies of metastases are however not always feasible in a patient, as the lesion may be unsafe to biopsy. If one lesion is biopsied, heterogeneity of tumor characteristics amongst lesions throughout the body is still unknown. In vivo imaging of hormone receptors has the potential to guide clinical decision making. The UMCG has extensive experience in PET imaging of ER with the tracer 18F-fluoroestradiol (FES). In this thesis recommendations on the use and interpretation of FES-PET scans for breast cancer patients are described. For instance we show how previous radiation therapy affects FES PET results. And in a clinical pilot study we show that the FES-PET can identify metastases that are less likely to respond to the combination of letrozole plus palbociclib.The search for new biomarkers and drug targets continues, and as such the androgen receptor (AR) is of interest. The role of this receptor in breast cancer is reviewed in this thesis. We show that the AR on metastases can be visualized throughout the body by 18F-fluorodihydrotestosterone (FDHT) PET in breast cancer patients and the effect of an AR-blocker can also be visualized. Prior to further implementation of these novel imaging techniques in routine clinical practice, additional steps are needed. We summarize the route of PET tracers from pre-clinical to first-in-human molecular imaging studies, and the potential steps to implement more PET tracers into clinical practice.

M3 - Thesis fully internal (DIV)

SN - 978-94-028-0983-1

PB - Rijksuniversiteit Groningen

CY - [Groningen]

ER -

Imaging hormone receptors in metastatic breast cancer patients

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