Interplay between Molecular Imaging and Tumor Modeling of Anti-Angiogenic Therapies

Abstract

Molecular imaging plays a crucial role in oncology, as it can unveil dynamics of biological processes before and during therapy. Angiogenesis is one of the key tumor hallmarks. Use of anti-angiogenic therapies, particularly those targeting the VEGF pathway, is a common treatment strategy. However, clinical outcomes have been rather disappointing. One of the key phenomena in response to anti-angiogenic therapies is the so-called “angiogenic flare”, rapid rebound of tumors after therapy cessation or during treatment breaks. In addition, prolonged exposure to anti-angiogenic agents leads to build-up of treatment resistance. A series of clinical trials using advanced molecular imaging techniques will be presented that has helped explaining the observed angiogenic flare, giving insights into potential treatment strategies.Tumor modeling helps “bridging the scales” between molecular processes (biological foundations of tumor growth and response to therapies), and observed molecular imaging (phenotypic expression in vivo). We have used tumor modeling based on patient-specific molecular imaging input to investigate potential mechanisms leading to treatment failures. Interplay between molecular imaging-driven clinical trials and tumor modeling will be presented as a role-model for better understanding of clinically observed phenomena and as a guiding tools to guide more successful future treatment strategies.