1. Early prediction of response Functional imaging Microarrays Proteomics

2. N=15 N=10N=5 Before RT During RT After RT Before RTDuring RTAfter RTBefore RTDuring RTAfter RT FDG171051811,54,51483 FMISO533 FLT831,5 tumour evolution: SUVmax

3. RECTUM GELATINE Rectum resection Styrofoam box Orientation sticks -20°C Formol scan 4 mm slices Validation of tumor delineation

4. Validation of Tumor Delineation T T T

5. MR CT FDG PET FLT PET Resection specimenPathology metabolism tracerproliferation tracer before therapy during therapy after therapy

6. T P Validation tumour volume MR-FDG with APO FDG-PET TVs delineated with the gradient-based method matched closer with the pathological TV than MR-based TV

7. Translational research in rectal cancer S SURGERY W 12-13 T0T1T2 Blood/ tissue samples

8. Pathological response according to tumor regression grading ChemoradiationCetuximab* + capecitabine (n=37) Oxaliplatin* + capecitabine (n=36) 5-FU alone (n=35) pCR 2 (5%) 5 (14%) 4 (11%) > 2 mm mesorectal margin 27 (73%) 30 (83%)

9. Translational research in rectal cancer Micro-arrays Immunohistochemistr y FISH GENESPROTEINS ELISA

10. Phase II study with cetuximab in rectal cancer TGF-α EGFR Fibro- inflammatory changes Ki67 Debucquoy et al, unpublished results

11. Effect of Bevacizumab on tumour response Marked response in all 6 patients Only microscopic disease in 5 patients Willett et al. J Clin Oncol 2005

12. Effect of bevacizumab on tumour vasculature Pretreatment Day 12 Patient IFP (mm Hg) 0 4.5 9.0 13.5 18.0 22.5 3456 IFP = interstitial fluid pressure Willett et al. Nat Med 2004