VEGF-SPECT with ¹¹¹In-bevacizumab in stage III/IV melanoma patients

Eur J Cancer. 2011 Jul;47(10):1595-602. doi: 10.1016/j.ejca.2011.02.009. Epub 2011 Mar 21.


Purpose: A feasibility study was performed to investigate the presence of VEGF in melanoma lesions by VEGF-SPECT with (111)In-bevacizumab. In addition the effect of a single therapeutic bevacizumab dose on (111)In-bevacizumab uptake was compared with VEGF levels in resected melanoma lesions.

Patients and methods: Eligible were patients with stage III/IV melanoma who presented with nodal recurrent disease. VEGF-SPECT was performed after administration of 100 Mbq (111)In-bevacizumab (8 mg) at days 0, 2, 4 and 7 post injection. Tumour visualisation and quantification were compared with CT and FDG-PET. On day 7 a single dose of 7.5mg/kg bevacizumab was administered intravenously. On day 21, a second tracer dose (111)In-bevacizumab was administered and scans were obtained on days 21, 25 and 28. Metastases were surgically resected within 2 weeks after the last VEGF-SPECT scan and immunohistological (IHC) VEGF tumour expression was compared with (111)In-bevacizumab tumour uptake.

Results: Nine patients were included. FDG-PET and CT detected both in total 12 nodal lesions which were all visualised by VEGF-SPECT. At baseline, (111)In-bevacizumab tumour uptake varied 3-fold between and 1.6 ± 0.1-fold within patients. After a therapeutic dose of bevacizumab there was a 21 ± 4% reduction in (111)In-bevacizumab uptake. The (111)In-bevacizumab tumour uptake in the second series positively correlated with the VEGF-A expression in the resected tumour lesions.

Conclusion: VEGF-SPECT could visualise all known melanoma lesions. A single dose of bevacizumab slightly lowered (111)In-bevacizumab uptake. Future studies should elucidate the role of VEGF-SPECT in the selection of patients and the individual dosing of bevacizumab treatment.

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Immunohistochemistry / methods
  • Indium Radioisotopes / chemistry
  • Infusions, Intravenous / methods
  • Male
  • Melanoma / drug therapy*
  • Melanoma / pathology*
  • Middle Aged
  • Neoplasm Metastasis
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Vascular Endothelial Growth Factor A / metabolism*


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Indium Radioisotopes
  • Vascular Endothelial Growth Factor A
  • Bevacizumab