Early prediction of response Functional imaging Microarrays Proteomics
N=15 N=10N=5 Before RT During RT After RT Before RTDuring RTAfter RTBefore RTDuring RTAfter RT FDG ,54,51483 FMISO533 FLT831,5 tumour evolution: SUVmax
RECTUM GELATINE Rectum resection Styrofoam box Orientation sticks -20°C Formol scan 4 mm slices Validation of tumor delineation
Validation of Tumor Delineation T T T
MR CT FDG PET FLT PET Resection specimenPathology metabolism tracerproliferation tracer before therapy during therapy after therapy
T P Validation tumour volume MR-FDG with APO FDG-PET TVs delineated with the gradient-based method matched closer with the pathological TV than MR-based TV
Translational research in rectal cancer S SURGERY W T0T1T2 Blood/ tissue samples
Pathological response according to tumor regression grading ChemoradiationCetuximab* + capecitabine (n=37) Oxaliplatin* + capecitabine (n=36) 5-FU alone (n=35) pCR 2 (5%) 5 (14%) 4 (11%) > 2 mm mesorectal margin 27 (73%) 30 (83%)
Translational research in rectal cancer Micro-arrays Immunohistochemistr y FISH GENESPROTEINS ELISA
Phase II study with cetuximab in rectal cancer TGF-α EGFR Fibro- inflammatory changes Ki67 Debucquoy et al, unpublished results
Effect of Bevacizumab on tumour response Marked response in all 6 patients Only microscopic disease in 5 patients Willett et al. J Clin Oncol 2005
Effect of bevacizumab on tumour vasculature Pretreatment Day 12 Patient IFP (mm Hg) IFP = interstitial fluid pressure Willett et al. Nat Med 2004