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Nuclear medicine scan could identify whomight benefit from aromatase inhibitortreatment
May 7, 2015
Society of Nuclear Medicine
A new, noninvasive nuclear medicine test can be used todetermine whether aromatase inhibitor treatment will beeffective for specific cancer patients, according to a recentstudy reported in The Journal of Nuclear Medicine. Theresearch shows that a PET scan with the ligand C-11-
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vorozole reliably detects aromatase in all body organs -demonstrating the value of its future use to pre-determinethe effectiveness of the treatment for breast, ovarian,endometrial and lung cancer patients.
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A new, noninvasive nuclear medicine test can beused to determine whether aromatase inhibitortreatment will be effective for specific cancerpatients, according to a recent study reported inThe Journal of Nuclear Medicine. The researchshows that a PET scan with the ligand C-11-vorozole reliably detects aromatase in all bodyorgans -- demonstrating the value of its future useto pre-determine the effectiveness of the treatmentfor breast, ovarian, endometrial and lung cancerpatients, potentially reducing unnecessarytreatment costs and adverse effects.
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Aromatase inhibitors are drugs that work by blocking the aromataseenzyme, which turns the androgen hormone into cancer-stimulatingestrogen. They are widely used in the adjuvant treatment of breast cancerand other endocrine conditions. However, no quantitative, noninvasivestudies had been done of the distribution and regulation of aromatase inliving humans.
Anat Biegon, PhD, corresponding author of the study, explains, "This is thefirst study conducted in living human subjects that surveys the whole body,comparing healthy young and old men and women."
For the study, 13 men and 20 women were injected intravenously with C-11-vorozole (111-296 MBq/subject), with PET data acquired over a 90-minute period. Each subject had four scans, two per day separated by twoto six weeks. Brain and torso or pelvic scans were included. Young womenwere scanned at two discrete phases of the menstrual cycle (midcycle andlate luteal). Men and postmenopausal women were also scanned afterpretreatment with a clinical dose of the aromatase inhibitor letrozole. Time-activity curves were obtained, and standardized uptake values (SUV) werecalculated for major organs, including brain, heart, lungs, liver, kidneys,spleen, muscle, bone, and male and female reproductive organs. Organand whole-body radiation exposures were calculated using OLINDAsoftware.
The study shows for the first time that the body organ with the largeststable capacity for estrogen biosynthesis is the male brain, closely followedby the female brain. Aromatase availability is slightly but consistently higherin all organs in men relative to women, with the exception of the ovary. Inaddition, aromatase availability in the ovary is tightly linked to the ovulatoryphase of the menstrual cycle in young women, with increased levelsevident in one ovary/cycle around the time of ovulation. Also of interest is
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the finding that aging and cigarette smoke reduce aromatase availability inthe brains of healthy men and women.
Dr. Biegon points out the significance of the study: "Research using in vitromethods indicates aromatase over expression is not limited to breastcancer and is evident in a considerable proportion of ovarian, endometrial,and lung tumors. This study provides methodological, baseline anddosimetry information supporting the use of PET and C-11 vorozole in thenon-invasive identification of individuals with disparate disorders who maybenefit from treatment with aromatase inhibitors." She notes, "It also offersthe ability to distinguish breast cancer patients who are not likely to benefitfrom this treatment, reducing unnecessary treatment costs and adverseeffects. Finally, aromatase imaging can be used in monitoring efficacy oftreatment with aromatase inhibitors and aid in the development of newdrugs in this class."
Another key finding relates to the differences between men and women. Dr.Biegon states, "Radiotracer uptake and the resultant radiation exposurecan be sex-dependent and strongly modulated by hormonal status. Nuclearmedicine procedures need to be adjusted for these factors when applied inwomen."
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The above story is based on materials provided by Society of NuclearMedicine . Note: Materials may be edited for content and length.
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Cite This Page :
Society of Nuclear Medicine. "Nuclear medicine scan could identify whomight benefit from aromatase inhibitor treatment." ScienceDaily.ScienceDaily, 7 May 2015..
1. A. Biegon, D. L. Alexoff, S. W. Kim, J. Logan, D. Pareto, D. Schlyer, G.-J. Wang, J. S. Fowler. Aromatase Imaging with [N-Methyl-11C]Vorozole PET in Healthy Men and Women. Journal of NuclearMedicine, 2015; 56 (4): 580 DOI: 10.2967/jnumed.114.150383
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