Abstract

Hypoxia—a common feature of the majority of solid tumors—is a negative prognostic factor, as it is associated with invasion, metastasis and therapy resistance. To date, a variety of methods are available for the assessment of tumor hypoxia, including the use of positron emission tomography (PET). A plethora of hypoxia PET tracers, each with its own strengths and limitations, has been developed and successfully validated, thereby providing useful prognostic or predictive information. The current review focusses on [18F]-HX4, a promising next-generation hypoxia PET tracer. After a brief history of its development, we discuss and compare its characteristics with other hypoxia PET tracers and provide an update on its progression into the clinic. Lastly, we address the potential applications of assessing tumor hypoxia using [18F]-HX4, with a focus on improving patient-tailored therapies.

Highlights

  • Hypoxia is a common feature of the majority of solid tumors and arises due to a disturbed balance between proliferation and oxygen supply [1]

  • One of the important objectives of assessing tumor hypoxia using positron emission tomography (PET) is the identification of patients with a poor prognosis, and, which individuals are more likely to benefit from therapies focusing on overcoming tumor hypoxia

  • Hypoxia is a common feature of most solid tumors and is associated with poor prognosis and resistance to conventional therapies

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Summary

Introduction

Hypoxia is a common feature of the majority of solid tumors and arises due to a disturbed balance between proliferation and oxygen supply [1]. The PET tracers be ablelevels to identify regions with oxygen should be detected, as therelevant latter regions be more important in determining themeans tumoral response to, within the clinically range,can regardless of tumor type or stage. This that both severely e.g., hypoxic fractionated radiotherapy [8,9]. It should be repeatable to allow both detection of hypoxia and return to normoxia; (10) it should be effective in multiple tumor types and stages

The Development of 18 F-HX4: A Promising Third-Generation Hypoxia PET Tracer
History
Aims and Results
Selection for Hypoxia-Targeted Therapies
Patient Stratification for FLASH Therapy
10. Patient Stratification for Systemic and Radiation Therapy
11. Conclusions

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