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Lutetium-177-octreo...
Lutetium-177-octreotate treatment of small intestine neuroendocrine tumors - Radiation biology as basis for optimization
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- Spetz, Johan (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiofysik,Sahlgrenska Cancer Center,Institute of Clinical Sciences, Department of Radiation Physics
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(creator_code:org_t)
- ISBN 9789162900458
- 2017
- Engelska.
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- Patients with neuroendocrine tumors (NETs) often have metastatic spread at the time of diagnosis. NETs frequently express somatostatin receptors (SSTR) that can be targeted by radiolabeled somatostatin analogs (e.g. 177Lu-octreotate). Despite being highly effective in animal models (e.g. the human small intestine NET GOT1 transplanted to nude mice), 177Lu-octreotate-based therapies have shown low cure rates in clinical studies. The cellular processes that underlie positive treatment response to 177Lu-octreotate are largely unknown. The aim of this work was to study the possibilities to optimize the therapeutic effects of 177Lu-octreotate in the GOT1 model in nude mice. A literature study of available data on radiolabeled somatostatin analogs on NETs in animal models was performed, to identify strategies for treatment optimization. To test these strategies, GOT1-bearing BALB/c nude mice were treated with non-curative amounts of 177Lu-octreotate in different treatment schedules including single administrations, priming (fractionated) administrations and combination treatment with hedgehog inhibitor sonidegib. Biodistribution and dosimetry studies were performed and anti-tumor effects were monitored by measuring tumor volume. Global transcriptional and proteomic responses in tumor samples were evaluated using RNA microarray and liquid chromatography mass spectrometry, respectively. 177Lu-octreotate therapy of GOT1 tumors xenotransplanted in nude mice resulted in tumor volume reduction. Priming administration resulted in increased anti-tumor effects and increased therapeutic window. Combination therapy using sonidegib and 177Lu-octreotate resulted in prolonged time to progression. The global transcriptional and proteomic analyses of 177Lu-octreotate treated tumor samples revealed time-specific responses in terms of affected biological functions. In conclusion, time-dependent changes in p53-related cell cycle regulation and apoptosis, angiogenesis, endoplasmic reticulum stress, and oxidative stress-related processes suggest possible niches for combination therapy at different time points after radionuclide therapy. Priming 177Lu-octreotate therapy and combination therapy using sonidegib and 177Lu-octreotate could be beneficial to patients with NE-tumors.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
- NATURVETENSKAP -- Biologi -- Bioinformatik och systembiologi (hsv//swe)
- NATURAL SCIENCES -- Biological Sciences -- Bioinformatics and Systems Biology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Cell- och molekylärbiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Cell and Molecular Biology (hsv//eng)
- NATURVETENSKAP -- Biologi -- Biokemi och molekylärbiologi (hsv//swe)
- NATURAL SCIENCES -- Biological Sciences -- Biochemistry and Molecular Biology (hsv//eng)
Nyckelord
- Peptide receptor radionuclide therapy
- PRRT
- somatostatin receptors
- SSTR
- midgut carcinoid
- radiogenomics
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