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Antivascular cancer treatments: functional assessments by dynamic contrast-enhanced magnetic resonance imaging

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Abstract

New anticancer therapeutics that target tumor blood vessels promise improved efficacy and tolerability in humans. Early phase 1 drug trials have shown that the maximum tolerated dose may be inappropriate for more advanced clinical studies with efficacy endpoints. More advanced clinical trials have demonstrated that morphologic assessments of tumor response are of limited value for gauging the efficacy of treatment. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can serve as pharmacodynamic indicator of biological activity for antivascular cancer drugs by helping to define the biologically active dose. DCE-MRI studies may also predict the efficacy of treatment on the basis of changes observed. If DCE-MRI is to be used for the selection of antivascular drugs that advance into efficacy trials, then it will be necessary to develop standardized approaches to measurement and robust analytic approaches with clear accepted endpoints specified prospectively that have biological validity. Such developments will be essential for multicenter trials in which it will be necessary to establish effective cross-site standardization of measurements and evaluation.

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Acknowledgments

The support of Cancer Research UK and the Childwick Trust, which support the work of the Clinical Magnetic Resonance Research Group at the Royal Marsden Hospital and at the Paul Strickland Scanner Centre, Mount Vernon Hospital, respectively, is gratefully acknowledged. We are grateful to Dr. Jane Taylor for assistance in the preparation of the illustrative material for this review.

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  1. Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex, HA6 2RN, United Kingdom

    A. R. Padhani

  2. Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research and The RoyalMarsden NHS Trust, Downs Road, Sutton, Surrey, SM2 5PT, United Kingdom

    M. O. Leach

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Padhani, A.R., Leach, M.O. Antivascular cancer treatments: functional assessments by dynamic contrast-enhanced magnetic resonance imaging. Abdom Imaging 30, 325–342 (2005). https://doi.org/10.1007/s00261-004-0265-5

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