18 FluoroDeoxyGlucose: Beyond Diagnosis to Use in Novel Therapy

Background: PET CT scan has revolutionized the treatment of several types of cancer especially Lymphoma (Hodgkin's Disease and aggressive Non Hodgkin Lymphoma), Non Small Cell Lung Cancer, Head and Neck Squamous Cell Cancers... [ view full abstract ]

Background: PET CT scan has revolutionized the treatment of several types of cancer especially Lymphoma (Hodgkin's Disease and aggressive Non Hodgkin Lymphoma), Non Small Cell Lung Cancer, Head and Neck Squamous Cell Cancers and various other cancers that express 18-FDG avidity. 18FDG PET CT provides structual and functional imformation and provides more accurate extent of disease spread and localization of malignancy. The high FDG concentration may be used to selectively kill all FDG avid tumor cells.

Methods: 18 Fluorodeoxyglucose is preferentially concentrated in tumor tissue due to high tumor activity (reportedly 200 times more glycolysis than normal tissue cells). Alkylating chemotherapy agents like Cyclophosphamide have high non cell cycle specific tumoricidal property. If we can successfully conjugate an alkylating agent with an 18FDG radio isotope, we can attain high concentrations of the chemotherapy drug within the tumor tissue while normal tissues are selectively spared (less toxicity). Massive preferential killing of tumor cells can be expected in such  a situation producing a Complete Response (CR) or a Partial Response (PR) of the tumor tissue be it localized disease or the distant metastasis.

Discussion: The new approach using FDG seems to be promising as it's expected to target both local and metastatic disease. The discussion provided here may be put into preclinical studies for studying the efficacy of this new therapeutic modality before clinical trials may be carried out.