Positron emission tomography (PET) and computed tomography (CT) have evolved as a pivotal diagnostic modality in the field of oncology. With its increasing application in staging and ready ...availability, it becomes imperative for committed radiation oncologists to possess a complete analysis and understanding of integration of molecular imaging, which can be helpful for radiation planning, while also acknowledging its possible limitations and challenges. A significant obstacle lies in the synthesis and design of tumor-specific bmolecules for diagnosing and treating cancer. The utilization of radiation in medical biochemistry and biotechnology, encompassing diagnosis, therapy, and control of biological systems, is encapsulated under the umbrella term "nuclear medicine". Notably, the application of various radioisotopes in pharmaceutics has garnered significant attention, particularly in the realm of delivery systems for drugs, DNA, and imaging agents. The present article provides a comprehensive review of use of novel techniques PET and CT with major positron-emitting radiopharmaceuticals currently in progress or utilized in clinical practice with their integration into imaging and radiation therapy.
Transhumanism, as a philosophical movement with ancient origins in the Renaissance period, promotes respect for reason and science and the application of scientific and technical conquests for the ...benefit of man, principles which are not fundamentally different from those of humanism. Like it or not, many of us will live to see their practical application: communication, computer science, robotics, AI (artificial intelligence), with multidisciplinary involvement. We looked at what the current practical applications are in an oncology service and where we foresee transhumanism (H+) fitting in the future. Today, access to medical information, epidemiological data, health policy, computerised treatment prescription, robotic surgery, unprecedented development of imaging techniques are concrete evidence of practical applications in oncology.The volume of information and the varied conditions of its application, with its specific details, the need for personalisation of treatment, the speed of technology’s development and artificial intelligence is beginning to outstrip the possibility of assimilation, even for physicians with a high IQ, with an adequate memory, bent on study, so that oncology will probably be one of the fields that will benefit from the introduction of AI.The conclusions are pro-progress, but also fatalistic. The usefulness and applicability of the new breakthroughs are useful: what doctor wouldn't want his patients to be cured? It's just that each of us is unique, or this divine uniqueness cannot be taught, especially when it comes to the empathy that the doctor displays towards the patients
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Background: Standard treatment for RM-HNSCC is a combination of cisplatin (P), 5-FU (F), and the epidermal growth factor receptor (EGFR) blocking monoclonal antibody cetuximab. ...CetuGEX is a new monoclonal antibody sharing the identical EGFR-binding domain with cetuximab, but a modified Fc part by a proprietary glycosylation method to optimize antibody dependent cellular cytotoxicity (ADCC). Methods: Patients with RM-HNSCC without relevant comorbidities were randomized to receive up to 6 cycles of P 100 mg/m
2
, F 4 x 1000 mg/m
2
/24hrs and CetuGEX vs. cetuximab. Initial dose of cetuximab was 400mg/m
2
, followed by weekly 250 mg/m
2
. CetuGEX was given as 990 mg, followed by weekly 720 mg. After end of combination treatment, patients received single agent antibody maintenance until disease progression or intolerable toxicity. Stratification factors included FcγRIIIa status, primary tumor site, EGFR pretreatment vs. naïve, and recurrent vs. metastatic disease. Primary endpoint was progression-free survival (PFS) by immune related response criteria (irRC). Secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR) and overall survival (OS) as well as safety and QoL. Results: During Jan 2014 and Feb 2016, 240 patients were accrued in 34 European centers, of which 123 received cetuximab and 117 CetuGEX. The median follow-up was 15 month until May 2017. No difference was observed for the primary endpoint of PFS by irRC median 27.7 (CetuGEX) and 26.4 (cetuximab) weeks; HR 1.003; 95%-CI 0.738 – 1.363; p = 0.98. No advantage of CetuGEX over cetuximab was observed for all other secondary efficacy endpoints and subgroup analyses by stratification factors. Infusion related reactions (IRR) were higher for CetuGEX (38.8%) than for cetuximab (5.7%) (Pearson chi
2
= 37.08; p < 0.0001), but without sequelae. Conclusions: The RESGEX study is the first head-to-head comparison of an ADCC-optimized to a conventional EGFR-directed antibody. The study failed to show superior efficacy of CetuGEX over cetuximab. Both compounds appear to have the same efficacy and a similar safety profile. Glycosylation changes in the Fc part induced more IRRs. Clinical trial information: NCT02052960.
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