Prevalence of hypoxia and correlation with glycolytic metabolism and angiogenic biomarkers in metastatic colorectal carc
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ORIGINAL ARTICLE
Prevalence of hypoxia and correlation with glycolytic metabolism and angiogenic biomarkers in metastatic colorectal carcinoma ST. Lee 1,2,3,4 & V. Muralidharan 5,6 & N. Tebbutt 6,7 & P. Wong 5 & C. Fang 2 & Z. Liu 2 & H. Gan 2,3,7 & J. Sachinidis 1 & K. Pathmaraj 1 & C. Christophi 5,6 & A. M. Scott 1,2,3,4 Received: 14 June 2020 / Accepted: 12 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Hypoxia is associated with aggressive tumour behaviour and can influence response to systemic therapy and radiotherapy. The prevalence of hypoxia in metastatic colorectal cancer is poorly understood, and the relationship of hypoxia to patient outcomes has not been clearly established. The aims of the study were to evaluate hypoxia in metastatic colorectal cancer with [18F]Fluoromisonidazole ([18F]FMISO PET) and correlate these findings with glycolytic metabolism ([18F]FDG PET) and angiogenic blood biomarkers and patient outcomes. Methods Patients with metastatic colorectal cancer received routine staging investigations and both [18F] FMISO PET and [18F] FDG PET scans. Correlative blood specimens were also obtained at the time of the [18F] FMISO PET scan. Patient follow-up was performed to establish progression-free survival. Results A total of 40 patients were recruited into the trial. [18F]FMISO and [18F]FDG PET scans showed a significant correlation of SUVmax (p = 0.003). A significant correlation of progression-free survival and [18F] FMISO TNR (p = 0.02) and overall survival with [18F]FMISO TNR (p = 0.003) and [18F]FDG TGV (p = 0.02) was observed. Serum levels of osteopontin, but not VEGF, correlated with [18F] FMISO and [18F]FDG PET scan parameters. Conclusion [18F]FMISO PET uptake in metastatic colorectal cancer significantly correlates with glycolytic metabolism and is predictive of progression-free and overall survival. These findings have implications for the assessment and treatment of metastatic colorectal cancer patients with novel therapies which affect tumour angiogenesis and hypoxia. Keywords Metastatic colorectal carcinoma . FMISO PET . VEGF . Osteopontin . Hypoxia
Introduction Colorectal carcinoma is the fourth most common malignancy with the third highest mortality worldwide [1]. More than 50% of patients develop metastatic disease, with the most common
visceral metastasis found in the liver. Hepatic resection for colorectal liver metastasis remains the only potentially curative therapy and has become the standard of care in this situation [2]. However, accurate staging is imperative in determining the suitability of patients for hepatic resection [3, 4],
This article is part of the Topical Collection on Oncology - Digestive tract * ST. Lee [email protected]
4
Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Australia
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Department of Surgery, Austin Health, Melbourne, Australia Department of Surgery, The University of Melbourne, Austin Health, Melbourne, Australia Department of Medical Oncology, Austin Hea
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