FDG PET/CT during neoadjuvant chemotherapy may predict response in ER-positive/HER2-negative and triple negative, but not in HER2-positive breast cancer
FDG PET/CT during neoadjuvant chemotherapy may predict response in ER-positive/HER2-negative and triple negative, but not in HER2-positive breast cancer
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DOI：
10.1016/j.breast.2012.12.020
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发表时间：
2013-10-01
期刊：
影响因子：
3.9
通讯作者：
Olmos, Renato A. Valdes
中科院分区：
文献类型：
--
作者：
Koolen, Bas B.;Pengel, Kenneth E.;Olmos, Renato A. Valdes
背景资料：在乳腺癌新辅助化疗（NAC）期间使用MRI进行反应监测是有希望的，但了解乳腺癌亚型是必不可少的。本研究的目的是评估乳腺癌亚型的相关性与18 F-FDG PET/CT.Methods的NAC治疗反应监测包括98名妇女与第二和第三阶段乳腺癌。PET/CT在NAC之前和之后6或8周进行。采用最大标准化摄取值（SUVmax）定量FDG摄取。肿瘤分为三种亚型：HER 2阳性、ER阳性/HER 2阴性和三阴性。手术时的肿瘤反应被二分（存在或不存在残留疾病）和顺序（乳腺反应指数，代表肿瘤分期的相对变化）评估。采用多变量回归和受试者工作特征（ROC）分析，以确定与病理respons.Results：（近）完全病理反应被认为是在19（76%）的25 HER 2阳性，7（16%）的45 ER阳性/HER 2阴性，和20（71%）的28三阴性肿瘤。病理反应的多变量回归表明FDG摄取的变化与乳腺癌亚型之间存在显著的相互作用。对于HER 2阳性肿瘤，ROC曲线下面积为0.35（0.12-0.64），对于ER阳性/HER 2阴性肿瘤，ROC曲线下面积为0.90（0.76-1.00），对于三阴性肿瘤，ROC曲线下面积为0.96（0.86-1.00）。我们没有发现年龄，阶段，组织学，或基线SUVmax和病理respons.Conclusion：响应监测PET/CT在NAC乳腺癌似乎是可行的，但依赖于乳腺癌亚型。PET/CT可以预测ER阳性/HER 2阴性和三阴性肿瘤的反应，但在HER 2阳性肿瘤中似乎不太准确。(C)2013爱思唯尔有限公司保留所有权利。
Background: Response monitoring with MRI during neoadjuvant chemotherapy (NAC) in breast cancer is promising, but knowledge of breast cancer subtype is essential. The aim of the present study was to evaluate the relevance of breast cancer subtypes for monitoring of therapy response during NAC with 18F-FDG PET/CT.Methods: Evaluation included 98 women with stages II and III breast cancer. PET/CTs were performed before and after six or eight weeks of NAC. FDG uptake was quantified using maximum standardized uptake values (SUVmax). Tumors were divided into three subtypes: HER2-positive, ER-positive/HER2-negative, and triple negative. Tumor response at surgery was assessed dichotomously (presence or absence of residual disease) and ordinally (breast response index, representing relative change in tumor stage). Multivariate regression and receiver operating characteristic (ROC) analyses were employed to determine associations with pathological response.Results: A (near) complete pathological response was seen in 19 (76%) of 25 HER2-positive, 7 (16%) of 45 ER-positive/HER2-negative, and 20 (71%) of 28 triple negative tumors. Multivariate regression of pathological response indicated a significant interaction between change in FDG uptake and breast cancer subtype. The area under the ROC curve was 0.35 (0.12-0.64) for HER2-positive, 0.90 (0.76-1.00) for ER-positive/HER2-negative, and 0.96 (0.86-1.00) for triple negative tumors. We found no association between age, stage, histology, or baseline SUVmax and pathological response.Conclusion: Response monitoring with PET/CT during NAC in breast cancer seems feasible, but is dependent on the breast cancer subtype. PET/CT may predict response in ER-positive/HER2-negative and triple negative tumors, but seems less accurate in HER2-positive tumors. (C) 2013 Elsevier Ltd. All rights reserved.