^(18)F-FETNIM PET/CT hypoxia imaging in non-small cell lung cancer:preliminary clinical observation

Objective:The aims of this study were to evaluate potential side effects of 18F-fluoroerythronitroimidazole (18F-FETNIM) as a new-type hypoxia-imaging agent and to investigate the feasibility of 18F-FETNIM PET imaging in advanced non-small cell lung cancer (NSCLC) patients and the correlations of hypoxia extent with tumor volume or pathological type. Methods: Twenty-six NSCLC patients were prospectively included in the study. PET/CT scans were performed 2 h after intravenous injection of 18F-FETNIM in all 26 patients. A pixel-by-pixel calculation of tumor to blood (T/B) activity ratio for all image planes was calculated. The number of pixels in the tumor volume with a T/B ratio≥ 1.5,indicating significant hypoxia,was determined and converted to mL units to measure the hypoxia volume (HV). Results: The images were clearly identified after 2 h post-injection of 18F-FETNIM. The tumors in 4 cases were not distinguished from background,while the remaining 22 displayed local 18F-FETNIM uptake in thoracic lesions moderately to markedly higher than background. There was no correlation between 18F-FETNIM uptake with pathological type. There were significant correlations of HV and also the T/B ratio with tumor volume. Conclusion:18F-FETNIM is a promising hypoxia-imaging agent which clinical use is safe and satisfactory. The preliminary study provides valuable methods and experience to its further research.

Single-cell RNA-sequencing reveals radiochemotherapy-induced innate immune activation and MHC-II upregulation in cervical cancer

Radiochemotherapy(RCT)is a powerful treatment for cervical cancer,which affects not only malignant cells but also the immune and stromal compartments of the tumor.Understanding the remodeling of the local ecosystem induced by RCT would provide valuable insights into improving treatment strategies for cervical cancer.In this study,we applied single-cell RNA-sequencing to paired pre-and post-RCT tumor biopsies from patients with cervical cancer and adjacent normal cervical tissues.We found that the residual population of epithelial cells post-RCT showed upregulated expression of MHC class II genes.Moreover,RCT led to the accumulation of monocytic myeloid-derived suppressor cells with increased pro-inflammatory features and CD16+NK cells with a higher cytotoxic gene expression signature.However,subclusters of T cells showed no significant increase in the expression of cytotoxic features post-RCT.These results reveal the complex responses of the tumor ecosystem to RCT,providing evidence of activation of innate immunity and MHC-II upregulation in cervical cancer.

Present status and progress of neoadjuvant chemoradiotherapy for esophageal cancer

Trimodality based on neoadjuvant chemoradiotherapy(nCRT)followed by surgery is gaining popularity as a treatment strategy for locally advanced esophageal cancer.In this review,we summarize the role of nCRT and the recommended nCRT regimens based on clinical trials and meta-analyses.We analyze the relationship of nCRT with pathologic complete response(pCR)and then identify potential predictive markers of response.Compared with surgery alone and neoadjuvant chemotherapy followed by surgery,trimodality provides longer survival and has the advantage of local control compared with definitive chemoradiotherapy.The standard regimen is a platinum-based regimen with a radiation dose range of 41.4–50.4 Gy by conventional fractionation.Evidence shows that patients with pCR tend to live longer than non-responders,indicating that pCR is a significant prognostic factor for patients with esophageal cancer.Individualized medicine requires predictive markers of individual patients based on their own genes.Currently,no definite marker is proved to be sufficiently sensitive and specific for use in clinical practice,although 18-fluorodeoxyglucose positron emission tomography shows promise in predicting response to nCRT.