Clinical Image

Imaging of Multi-Drug Resistance (MDR)

Karen A. Kurdziel*
Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, USA


*Corresponding author: Karen A. Kurdziel, Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, USA

Published: 05 Sep, 2017
Cite this article as: Kurdziel KA. Imaging of Multi-Drug Resistance (MDR). Clin Oncol. 2017; 2: 1332.

Clinical Image

The figure provided shows PET/CT imaging of 18F-fluoropaclitaxel [1-3] a paclitaxel (Taxol™) analog and experimental (not-FDA approved) imaging agent. Its uptake represents the biodistribution of this commonly used chemotherapeutic and, as a substrate for P-glycoprotein (Pgp), it indirectly images PgP expression and function. Pgp-mediated Multi-Drug Resistance (MDR) is a common category of drug resistance. Paclitaxel inhibits mitosis by binding to tubulin preventing its polymerization into microtubules needed for cell growth. If a tumor shows uptake of 18F-fluoropaclitaxel, it would suggest that the tumor will respond to paclitaxel while lack of uptake (like in the majority of the tumor in this case) indicates the likelihood of Pgp-mediated multi-drug resistance, requiring treatment to include a Pgp inhibitor or use of an alternative drug.


Figure 1

Another alt text

Figure 1

Acknowledgement

This research was supported [in part] by the Intramural Research Program of the NIH, NCI, CCR.


References

  1. Kurdziel KA, Kalen JD, Hirsch JI, Wilson JD, Bear HD, Logan J, et al. Human dosimetry and preliminary tumor distribution of 18F-fluoropaclitaxel in healthy volunteers and newly diagnosed breast cancer patients using PET/CT. J Nucl Med. 2011; 52(9): 1339–1345.
  2. Kurdziel KA, Kiesewetter DO. PET imaging of multidrug resistance in tumors using 18F-fluoropaclitaxel. Curr Top Med Chem. 2010; 10(17): 1792-1798.
  3. Kiesewetter DO, Jagoda EM, Kao CH, Ma Y, Ravasi L, Shimoji K, et al. Iodopaclitaxel derivatives: synthesis and biological evaluation. Nuclear medicine and biology. 2003; 30(1): 11-24.