Targeting Hypoxia to Improve Non-Small Cell Lung Cancer Outcome.
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Date
2018-01-01ICR Author
Author
Salem, A
Asselin, M-C
Reymen, B
Jackson, A
Lambin, P
West, CML
O'Connor, JPB
Faivre-Finn, C
Type
Journal Article
Metadata
Show full item recordAbstract
Oxygen deprivation (hypoxia) in non-small cell lung cancer (NSCLC) is an important factor in treatment resistance and poor survival. Hypoxia is an attractive therapeutic target, particularly in the context of radiotherapy, which is delivered to more than half of NSCLC patients. However, NSCLC hypoxia-targeted therapy trials have not yet translated into patient benefit. Recently, early termination of promising evofosfamide and tarloxotinib bromide studies due to futility highlighted the need for a paradigm shift in our approach to avoid disappointments in future trials. Radiotherapy dose painting strategies based on hypoxia imaging require careful refinement prior to clinical investigation. This review will summarize the role of hypoxia, highlight the potential of hypoxia as a therapeutic target, and outline past and ongoing hypoxia-targeted therapy trials in NSCLC. Evidence supporting radiotherapy dose painting based on hypoxia imaging will be critically appraised. Carefully selected hypoxia biomarkers suitable for integration within future NSCLC hypoxia-targeted therapy trials will be examined. Research gaps will be identified to guide future investigation. Although this review will focus on NSCLC hypoxia, more general discussions (eg, obstacles of hypoxia biomarker research and developing a framework for future hypoxia trials) are applicable to other tumor sites.
Collections
Subject
Humans
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Antineoplastic Agents
Radiation-Sensitizing Agents
Positron-Emission Tomography
Magnetic Resonance Imaging
Radiosurgery
Clinical Trials as Topic
Biomarkers, Tumor
Tumor Hypoxia
Research team
Quantitative Biomedical Imaging
Language
eng
Date accepted
2017-07-03
License start date
2018-01
Citation
Journal of the National Cancer Institute, 2018, 110 (1)
Publisher
OXFORD UNIV PRESS INC