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NCI grant recipient Ralph Weissleder, M.D., Ph.D., and colleagues at the Massachusetts General Hospital, Harvard Medical School, and the Netherlands' University Medical Center reported in June 2003 that these nano-sized magnetic particles can enhance MRI enough to diagnose elusive lymph-node metastases in prostate cancer. The investigators correctly identified all 33 patients in their study whose prostate cancer had spread, or metastasized, to the lymph nodes.
Currently, determining whether prostate cancer has metastasized requires an invasive biopsy, in which lymph nodes near the prostate gland are removed and examined in the laboratory. That may change, however, if FDA approval is received for this MRI-enhancing agent known as Combidex®.
Accurate staging can dramatically affect treatment choices and outcome for many cancers, including prostate cancer and breast cancer, in which Combidex® is also being studied. When prostate cancer is still confined to the prostate, the disease is often treated with radical prostatectomy, watchful waiting, or radiation. When it has spread or metastized to lymph nodes, however, treatment typically includes more aggressive hormone therapy plus radiation.
If approved for clinical use, "Combidex® could improve cancer staging and thus change the management of the patient," says John M. Hoffman, M.D., chief of the Molecular Imaging Branch of NCI's Cancer Imaging Program. "Unnecessary surgeries could possibly be significantly reduced, and patients could get the most appropriate therapies for their stage of cancer."
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