• de VriesElisabeth G EEGEDepartment of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. e.de.vries@umcg.nl., Laura Kist de Ruijter, Lub-de HoogeMarjolijn NMNDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Univ, Rudi A Dierckx, Sjoerd G Elias, and Sjoukje F Oosting.
• Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands. e.de.vries@umcg.nl.
• Nat Rev Clin Oncol. 2019 Apr 1; 16 (4): 241-255.

AbstractEffective patient selection before or early during treatment is important to increasing the therapeutic benefits of anticancer treatments. This selection process is often predicated on biomarkers, predominantly biospecimen biomarkers derived from blood or tumour tissue; however, such biomarkers provide limited information about the true extent of disease or about the characteristics of different, potentially heterogeneous tumours present in an individual patient. Molecular imaging can also produce quantitative outputs; such imaging biomarkers can help to fill these knowledge gaps by providing complementary information on tumour characteristics, including heterogeneity and the microenvironment, as well as on pharmacokinetic parameters, drug-target engagement and responses to treatment. This integrative approach could therefore streamline biomarker and drug development, although a range of issues need to be overcome in order to enable a broader use of molecular imaging in clinical trials. In this Perspective article, we outline the multistage process of developing novel molecular imaging biomarkers. We discuss the challenges that have restricted the use of molecular imaging in clinical oncology research to date and outline future opportunities in this area.

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