The use of perfusion CT for the evaluation of therapy combining AZD2171 with gefitinib in cancer patients

Eur Radiol. 2007 Jul;17(7):1700-13. doi: 10.1007/s00330-006-0425-9. Epub 2006 Oct 27.

Abstract

The purpose of this study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (CTP) in evaluating the hemodynamic response of tumors in the chest and abdomen treated with a combination of AZD2171 and gefitinib. Thirteen patients were examined just before and every 4-6 weeks after starting therapy. Following intravenous injection of a contrast agent, dynamic image acquisition was obtained at the level of a selected tumor location. To calculate perfusion, the maximum-slope method was used. Pre-treatment average perfusion for extra-hepatic masses was 84 ml/min/100 g, for liver masses arterial perfusion was 25 ml/min/100 g, and a portal perfusion of 30 ml/min/100 g was found. After the administration of AZD2171 and gefitinib, in extra-hepatic masses an initial decrease in perfusion of 18% was followed by a plateau and in liver masses an initial decrease of 39% within the lesions and of 36% within a rim region surrounding the lesions was followed by a tendency to recovery of hepatic artery flow. In conclusion, CTP is feasible in showing changes of perfusion induced by anti-angiogenic therapy.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Administration, Oral
  • Adult
  • Aged
  • Angiography*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Contrast Media / administration & dosage
  • Disease Progression
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Gefitinib
  • Humans
  • Image Processing, Computer-Assisted*
  • Injections, Intravenous
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / secondary
  • Male
  • Mediastinal Neoplasms / diagnostic imaging
  • Mediastinal Neoplasms / drug therapy*
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / drug therapy*
  • Pelvic Neoplasms / diagnostic imaging
  • Pelvic Neoplasms / drug therapy*
  • Pleural Neoplasms / diagnostic imaging
  • Pleural Neoplasms / drug therapy*
  • Prognosis
  • Quinazolines / administration & dosage*
  • Quinazolines / adverse effects
  • Tomography, Spiral Computed*

Substances

  • Contrast Media
  • Quinazolines
  • cediranib
  • Gefitinib