Tumor monitoring

A second animal model uses H-ros transgenic mice (Oncomouse ) which spontaneously develop mammary and salivary tumors.97 This model is considered to be more relevant to human cancer in that tumor initiation and growth is endogenous, in contrast to nude mouse tumor explants. Mice with palpable tumors between 50 and 350 mm3 were treated with either the ester prodrug 18c (40 mg/kg, once daily, s.c.) or vehicle, and the size of the tumors monitored over time.44 While... 

A great deal of attention has been recently afforded the orthotopic injection of cancer cells. Even a cursory review of the literature shows that most investigators have injected mmor cells subcutaneously. The reasons are simple—injections are convenient, tumor monitoring and measuring are convenient and skill level... 

M.P. Chien, A.S. Carlini, D. Hu, C.V. Barback, A.M. Rush, D.J. Hall, G. Orr, and N.C. Gianneschi, Enzyme-directed assembly of nanoparticles in tumors monitored by in vivo whole animal imaging and ex vivo super-resolution fluorescence imaging, J Am Chem Soc, 135 (50), 18710-3, 2013. 

Acid- and alkaline phosphatases act on a variety of mono- and multiple phosphate carrying low molecular mass molecules. In addition, they hydrolyze many, but not all, phosphoproteins. They are in use for decades to easily screen for diseases, however, somewhat unspe-cifially. For instance, acid phosphatase is used as biomarker for prostate cancer, and alkaline phosphatase to monitor bone (de-) mineralization and liver tumors. 

The Chilkoti group applied the local injection approach for intratumoral dmg delivery. ELP[V-120], with a transition at 27°C, was designed and labeled with C, 1 or 1 for radiotherapy. The first two labels were used to monitor tumor retention of the ELP and the last label was addressed to equip the ELP with antitumor activity. It was found that mice treated with 1-labeled ELP[V-120] experienced a significantly prolonged survival over those treated with saline [97]. 

The growth and spread of thyroid carcinoma is stimulated hy TSH. An important component of thyroid carcinoma management is the use ofLT4 to suppress TSH secretion. Early in therapy, patients receive the lowest LT4 dose sufficient to fully suppress TSH to undetectable levels. Controlled trials show that suppressive LT4 therapy reduces tumor growth and improves survival. These patients are purposefully overtreated with LT4 and rendered subclinically hyperthyroid. Postmenopausal women should receive aggressive osteoporosis therapy to prevent LT4-induced bone loss. Other thyrotoxic complications, such as atrial fibrillation, should be monitored and managed appropriately. 

LT4 doses sufficient to suppress tumor growth may result in a suppressed TSH and mild hyperthyroidism. These patients must be monitored closely for complications of the mild hyperthyroid state, such as bone mineral loss and development of atrial fibrillation. 

Since up to 10% of pituitary tumors may recur within 15 years following surgery,6,14 continual postoperative monitoring is recommended. 

Monitor patients every 3 to 6 months for a reduction in lesions or disease remission. Monitoring parameters include patient compliance, disease remission, and benign or cancerous tumors. 

Locally advanced breast cancer often is treated with neoadjuvant therapy to make the tumor surgically respectable. During neoadjuvant chemotherapy, laboratory values to monitor chemotherapy toxicity are obtained prior to each cycle of chemotherapy, and a physical examination and ultrasound exams to detect size of tumor are performed after the cycles of neoadjuvant therapy are completed. After a complete surgical resection, monitoring proceeds as described earlier for early breast cancer. 

Monitor patient for signs of response of tumor to chemotherapy. 

Overall survival is affected by the success of the initial surgery to debulk the tumor to less than 1 cm of disease and response to first-line chemotherapy. The CA-125 level should be monitored with each cycle, and at least a 50% reduction in CA-125 after four cycles of taxane/platinum chemotherapy is related to an improved prognosis. Patients who achieve a complete response should have follow-up examinations every 3 months, including CA-125 determination, physical examination, pelvic examination, and appropriate diagnostic scans (e.g., CT scan, MRI, or PET scan) and should be evaluated for the detection of disease. Evaluate patients for resolution of any residual chemotherapy-related side effects, including neuropathies, nephrotoxicity, ototoxicity, myelosuppression, and nausea/vomiting. 

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