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The Role of Modern Medical Imaging in Evaluation of Tumor Response to Vascular Targeting Therapy

机译:现代医学成像在评估血管靶向治疗中的作用

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The unique features of tumor vasculature represent an attractive target that can be utilized by vascular targeting therapy (VTT). The pharmaceuticals applied in VTT are classified into angiogenesis inhibiting agents (AIAs) and vascular disrupting agents (VDAs) according to their mechanisms of action. AIAs inhibit the formation of new vessels, while VDAs selectively destroy the existing tumor vessels. Both reduce the blood supply, cause the tumor necrosis, and delay the tumor growth, but they cannot eradiate tumor. This novel VTT challenges the traditional criteria for therapeutic evaluation based on tumor size. Functional and metabolic studies are thus necessary to monitor the early vascular alterations and to estimate the therapeutic efficacy for prompt justification and adjustment in oncological patients under the VTT regimen. In this article, we review the characteristics of tumor vessels, classification of VTT, and lead drugs in clinical development. We also envision, in addition to the conventional anatomy-based criteria, comprehensive imaging protocols for the assessment of tumor response to VTT combining morphological, functional and metabolic imaging biomarkers, applicable for magnetic resonance imaging, computed tomography, positron emission tomography, and ultrasound.
机译:肿瘤脉管系统的独特特征代表了可通过血管靶向治疗(VTT)使用的含有吸引力的靶标。根据其作用机制,将vtt应用于血管生成的药物分为血管生成抑制剂(AIAs)和血管破坏剂(VDA)。 AIAS抑制新血管的形成,而VDA选择性地破坏现有的肿瘤血管。两者都减少血液供应,导致肿瘤坏死,延缓肿瘤生长,但它们不能消除肿瘤。基于肿瘤大小,这部小型VTT挑战了传统的治疗评价标准。因此,需要函数和代谢研究来监测早期血管改变,并估计VTT方案下肿瘤患者迅速理由和调整的治疗效果。在本文中,我们审查了肿瘤血管,VTT分类的特征,临床发展中的铅药物。除了以常规的基于解剖学的标准外,还设想了用于评估肿瘤反应的综合成像协议,用于组合形态,功能和代谢成像生物标志物,适用于磁共振成像,计算机断层扫描,正电子发射断层扫描和超声波。

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