An approval of a specific treatment program from 4th July 2019 – Diagnostics of solid tumor hypoxia with [18F]FMISO

Fluormisonidazole (FMISO) performs a compound from the group of nitroimidazoles which has also been extensively investigated in the past as hypoxic cell sensitizer. It was found that FMISO accumulates by simple diffusion in hypoxic tissue in proportion to cell hypoxia. The tissue distribution of FMISO labelled by 18F positron emitter can be detected using a PET camera. This makes it suitable to monitor the degree of tumor accumulation, including pharmacokinetics and pharmacodynamics, following intravenous administration of [18F]FMISO. For the first time, [18F]FMISO was designed as a positron radiopharmaceutical to monitor tumor hypoxia with PET in 1984. Subsequently, [18F]FMISO was repeatedly tested in in vitro studies on tumor tissues with various types of tumor cells and it was shown that decreasing accumulation [18F]FMISO is related to an increase in oxygen concentration.

Please see the scientific articles related to hypoxia below:

 Jun Santo et al.: Advantage of FMISO-PET over FDG-PET for predicting histological response to preoperative chemotherapy in patients with oral squamous cell carcinoma, Eur J Nucl Med Mol Imaging (2014) 41:2031–2041.

 Anna Bandurska-Luque et al.: FMISO-PET-based lymph node hypoxia adds to the prognostic value of tumor only hypoxia in HNSCC patients, Radiotherapy and Oncology 130 (2019) 97–103.

 I N Fleming et al: Imaging tumour hypoxia with positron emission tomography, British Journal of Cancer (2015) 112, 238–250.

 Daniel Zips et al.: Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer, Radiotherapy and Oncology 105 (2012) 21–28.