Phase I Trial of the Antivascular Agent Combretastatin A4 Phosphate on a 5-Day Schedule to Patients With Cancer: Magnetic Resonance Imaging Evidence for Altered Tumor Blood Flow

Stevenson, James P.; Rosen, Mark; Sun, Weijing; Gallagher, Maryann; Haller, Daniel G.; Vaughn, David J.; Giantonio, Bruce J.; Zimmer, Ross; Petros, William P.; Stratford, Michael R.L.; Chaplin, David J.; Young, Scott L.; Schnall, Mitchell D.; O’Dwyer, Peter J.

doi:10.1200/jco.2003.12.986

Cited by 284 publications

(204 citation statements)

References 28 publications

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“…Most were small cohort single-centre phase I trials in patients with advanced solid tumours, although a small number of phase II trials have incorporated DCE-MRI (Wedam et al, 2006). Marked variation in tumour size (Evelhoch et al, 2004), anatomy and pathophysiology and previous treatment (Morgan et al, 2003) have made data evaluation difficult and may have masked subtle drug effects, prompting a move towards stricter inclusion criteria (Morgan et al, 2003;Mross et al, 2005a;O'Dwyer et al, 2005) or using an intra-patient dose escalation design (Jayson et al, 2002;Stevenson et al, 2003).…”

Section: Data Qualitymentioning

confidence: 99%

DCE-MRI biomarkers in the clinical evaluation of antiangiogenic and vascular disrupting agents

et al. 2007

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Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is now frequently used in early clinical trial assessment of antiangiogenic and vascular disrupting compounds. Evidence of drug efficacy and dose-dependent response has been demonstrated with some angiogenesis inhibitors. This review highlights the critical issues that influence T 1 -weighted DCE-MRI data acquisition and analysis, identifies important areas for future development and reviews the clinical trial findings to date.

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Section: Data Qualitymentioning

confidence: 99%

DCE-MRI biomarkers in the clinical evaluation of antiangiogenic and vascular disrupting agents

et al. 2007

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“…In a second phase-I study, Stevenson et al (2003) used a daily infusion for 5 days every 3 weeks . Thirty-seven patients received 133 cycles.…”

Section: Combretastatin A4 Phosphatementioning

confidence: 99%

Vascular disrupting agents in clinical development

2007

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Growth of human tumours depends on the supply of oxygen and nutrients via the surrounding vasculature. Therefore tumour vasculature is an attractive target for anticancer therapy. Apart from angiogenesis inhibitors that compromise the formation of new blood vessels, a second class of specific anticancer drugs has been developed. These so-called vascular disrupting agents (VDAs) target the established tumour vasculature and cause an acute and pronounced shutdown of blood vessels resulting in an almost complete stop of blood flow, ultimately leading to selective tumour necrosis. As a number of VDAs are now being tested in clinical studies, we will discuss their mechanism of action and the results obtained in preclinical studies. Also data from clinical studies will be reviewed and some considerations with regard to the future development are given.

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“…Although biochemical recurrence after radiotherapy for prostate cancer is often treated with immediate or delayed androgen deprivation therapy (ADT), documenting local recurrence after LDR brachytherapy may provide additional therapeutic options (9,10). For brachytherapy practitioners, understanding the patterns of local recurrence after treatment may inform patient selection or alter implant techniques in certain cases to optimize dosimetry.…”

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confidence: 99%

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Valle¹,

Greer²,

Shih³

et al. 2018

Diagn Interv Radiol

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PURPOSEProstate multiparametric magnetic resonance imaging (mpMRI) has utility in detecting post-radiotherapy local recurrence. We conducted a multireader study to evaluate the diagnostic performance of mpMRI for local recurrence after low dose rate (LDR) brachytherapy. METHODSA total of 19 patients with biochemical recurrence after LDR brachytherapy underwent 3T endorectal coil mpMRI with T2-weighted imaging, dynamic contrast-enhanced imaging (DCE) and diffusion-weighted imaging (DWI) with pathologic confirmation. Prospective reads by an experienced prostate radiologist were compared with reads from 4 radiologists of varying experience. Readers identified suspicious lesions and rated each MRI detection parameter. MRI-detected lesions were considered true-positive with ipsilateral pathologic confirmation. Inferences for sensitivity, specificity, positive predictive value (PPV), kappa, and index of specific agreement were made with the use of bootstrap resampling. RESULTSPathologically confirmed recurrence was found in 15 of 19 patients. True positive recurrences identified by mpMRI were frequently located in the transition zone (46.7%) and seminal vesicles (30%). On patient-based analysis, average sensitivity of mpMRI was 88% (standard error [SE], 3.5%). For highly suspicious lesions, specificity of mpMRI was 75% (SE, 16.5%). On lesion-based analysis, the average PPV was 62% (SE, 6.7%) for all lesions and 78.7% (SE, 10.3%) for highly suspicious lesions. The average PPV for lesions invading the seminal vesicles was 88.8% (n=13). The average PPV was 66.6% (SE, 5.8%) for lesions identified with T2-weighted imaging, 64.9% (SE, 7.3%) for DCE, and 70% (SE, 7.3%) for DWI. CONCLUSIONThis series provides evidence that mpMRI after LDR brachytherapy is feasible with a high patient-based cancer detection rate. Radiologists of varying experience demonstrated moderate agreement in detecting recurrence.You may cite this article as: Valle LF, Greer MD, Shih JH, et al. Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy. Diagn Interv Radiol 2018; 24: 46-53.

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Phase I Trial of the Antivascular Agent Combretastatin A4 Phosphate on a 5-Day Schedule to Patients With Cancer: Magnetic Resonance Imaging Evidence for Altered Tumor Blood Flow

Cited by 284 publications

References 28 publications

DCE-MRI biomarkers in the clinical evaluation of antiangiogenic and vascular disrupting agents

DCE-MRI biomarkers in the clinical evaluation of antiangiogenic and vascular disrupting agents

Vascular disrupting agents in clinical development

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

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