| 1. |
- Altena, Renske, et al.
(författare)
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HER2-låg bröstcancer ny entitet : ökar behandlingsmöjligheterna
- 2022
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 119
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Forskningsöversikt (refereegranskat)abstract
- Breast cancer is the most common form of cancer among women in Sweden. Several decades ago it was recognized that the Human epidermal growth factor receptor 2 (HER2) is involved in a critical growth system for breast cancer cells. Overexpression of HER2 (immunohistochemistry [IHC] 2+/3+, in situ hybridization [ISH] positive) is present in 15 percent of all breast cancers.HER2-low breast cancer has been discovered as a separate entity; the most commonly used definition so far is IHC 1+/2+ and ISH negative, but general consensus is still lacking. Clinical studies with the HER2 antibody drug conjugate trastuzumab deruxtecan (Enhertu) have shown impressive antitumor activity among women with advanced HER2-low breast cancer and this is expected to become part of routine treatment in the near future. Research is needed to establish refined ways to define HER2-low breast cancer, and a possible role lies in new imaging methods such as HER2 positron emission tomography (PET) with a [68Ga]Ga-ABY-025 tracer.
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| 2. |
- Eissler, Nina, et al.
(författare)
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Affibody PET Imaging of HER2-Expressing Cancers as a Key to Guide HER2-Targeted Therapy
- 2024
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Ingår i: Biomedicines. - : MDPI. - 2227-9059. ; 12:5
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Forskningsöversikt (refereegranskat)abstract
- Human epidermal growth factor receptor 2 (HER2) is a major prognostic and predictive marker overexpressed in 15-20% of breast cancers. The diagnostic reference standard for selecting patients for HER2-targeted therapy is based on the analysis of tumor biopsies. Previously patients were defined as HER2-positive or -negative; however, with the approval of novel treatment options, specifically the antibody-drug conjugate trastuzumab deruxtecan, many breast cancer patients with tumors expressing low levels of HER2 have become eligible for HER2-targeted therapy. Such patients will need to be reliably identified by suitable diagnostic methods. Biopsy-based diagnostics are invasive, and repeat biopsies are not always feasible. They cannot visualize the heterogeneity of HER2 expression, leading to a substantial number of misdiagnosed patients. An alternative and highly accurate diagnostic method is molecular imaging with radiotracers. In the case of HER2, various studies demonstrate the clinical utility and feasibility of such approaches. Radiotracers based on Affibody((R)) molecules, small, engineered affinity proteins with a size of similar to 6.5 kDa, are clinically validated molecules with favorable characteristics for imaging. In this article, we summarize the HER2-targeted therapeutic landscape, describe our experience with imaging diagnostics for HER2, and review the currently available clinical data on HER2-Affibody-based molecular imaging as a novel diagnostic tool in breast cancer and beyond.
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| 3. |
- Harms, Hendrik J, et al.
(författare)
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First-Pass Techniques Applied to Standard Dynamic Cardiac PET : A reappraisal of Old Invasive Techniques to Assess Cardiac Function
- 2020
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Ingår i: Seminars in nuclear medicine. - : Elsevier BV. - 0001-2998 .- 1558-4623. ; 50:4, s. 349-356
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Forskningsöversikt (refereegranskat)abstract
- Cardiac PET is increasingly performed with dynamic imaging to measure tracer pharmacokinetics in the myocardium. If the early time frames of the PET protocol are sufficiently short and the total amount of injected radioactivity is correctly measured the indicator dilution principle can be applied to PET with most tracers in clinical use, similar to invasive and other noninvasive techniques. The first-pass of the tracer through the heart and lungs can be used to quantify some highly important aspects of cardiovascular function, such as forward cardiac output, transit times, and partial volumes in the central compartments. Additionally, ECG-gated first pass images provide direct access to cardiac volumes and ejection fractions, even for tracers with poor trapping in the myocardial wall, for instance 15O-water. This review summarizes the basic approaches of the indicator dilution principle in clinical use with invasive techniques, and how these techniques can be integrated into a cardiac PET scan.
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| 4. |
- Sörensen, Jens
(författare)
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How Does the Patient Benefit from Clinical PET?
- 2012
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Ingår i: Theranostics. - : Ivyspring International Publisher. - 1838-7640. ; 2:5, s. 427-436
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Forskningsöversikt (refereegranskat)abstract
- Clinical molecular imaging by use of PET and PET/CT is increasingly important in routine oncological practice worldwide. A vast majority of clinical PET investigations are performed with [F-18]-fluorodeoxyglucose (FDG), but there is a growing interest in novel molecular probes among scientists and clinicians. Beyond FDG, a small number of different tracers have been shown to be of clinical value. With a growing commercial interest in tracer development, many more are under investigation. This review provides some examples of clinical situations where tracers other than FDG have been found useful and an outlook towards technical and regulatory development needed to allow the full impact of clinical PET to benefit the individual patient.
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| 5. |
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| 6. |
- Tolmachev, Vladimir, et al.
(författare)
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The emerging role of radionuclide molecular imaging of HER2 expression in breast cancer
- 2021
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Ingår i: Seminars in Cancer Biology. - : Elsevier BV. - 1044-579X .- 1096-3650. ; 72, s. 185-197
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Forskningsöversikt (refereegranskat)abstract
- Targeting of human epidermal growth factor type 2 (HER2) using monoclonal antibodies, antibody-drug conjugates and tyrosine kinase inhibitors extends survival of patients with HER2-expressing metastatic breast cancer. High expression of HER2 is a predictive biomarker for such specific treatment. Accurate determination of HER2 expression level is necessary for stratification of patients to targeted therapy. Non-invasive in vivo radionuclide molecular imaging of HER2 has a potential of repetitive measurements, addressing issues of heterogeneous expression and conversion of HER2 status during disease progression or in response to therapy. Imaging probes based of several classes of targeting proteins are currently in preclinical and early clinical development. Both preclinical and clinical data suggest that the most promising are imaging agents based on small proteins, such as single domain antibodies or engineered scaffold proteins. These agents permit a very specific high-contrast imaging at the day of injection.
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