PET imaging of zirconium-89 labelled cetuximab: A phase I trial in patients with head and neck and lung cancer

Judith van Loon, Aniek J G Even, Hugo J W L Aerts, Michel Öllers, Frank Hoebers, Wouter van Elmpt, Ludwig Dubois, Anne-Marie C Dingemans, Roy I Lalisang, Pascal Kempers, Boudewijn Brans, Véronique Winnepenninckx, Ernst-Jan Speel, Eric Thunnissen, Kim M Smits, Ronald Boellaard, Danielle J Vugts, Dirk De Ruysscher, Philippe Lambin

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BACKGROUND AND PURPOSE: PET imaging of cetuximab uptake may help selecting cancer patients with the highest chance of benefit. The aim of this phase I trial was to determine the safety of the tracer (89)Zr-cetuximab and to assess tumour uptake.

METHODS: Two dose schedules were used; two consecutive doses of 60MBq (89)Zr-cetuximab or a single dose of 120MBq, both preceded by 400mg/m(2) of unlabelled cetuximab. Toxicity (CTCAE 3.0) was scored twice weekly. PET-CT scans were acquired on days 4, 5 and 6 (step 1) or 5, 6, 7 (step 2). Because tumour uptake could not be assessed satisfactorily, a third step was added including EGFR overexpressing tumours.

RESULTS: Nine patients were included (6 NSCLC; 3 HNC). No additional toxicity was associated with administration of (89)Zr-cetuximab compared to standard cetuximab. A tumour to blood ratio (TBR)>1 was observed in all but one patient, with a maximum of 4.56. TBR was not different between dose schedules. There was a trend for higher TBR at intervals>5days after injection.

CONCLUSIONS: Both presented (89)Zr-cetuximab administration schedules are safe. The recommended dose for future trials is 60MBq, with a minimum time interval for scanning of 6days.

Original languageEnglish
JournalRadiotherapy and Oncology
Publication statusPublished - 21 Dec 2016

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