(89)Zr-trastuzumab PET supports clinical decision making in breast cancer patients, when HER2 status cannot be determined by standard work up.
(89)Zr-trastuzumab PET supports clinical decision making in breast cancer patients, when HER2 status cannot be determined by standard work up.
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DOI：
10.1007/s00259-018-4099-8
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发表时间：
2018-12
影响因子：
9.1
通讯作者：
Schröder CP
中科院分区：
文献类型：
--
作者：
Bensch F;Brouwers AH;Lub-de Hooge MN;de Jong JR;van der Vegt B;Sleijfer S;de Vries EGE;Schröder CP
有关乳腺癌（BC）中人表皮生长因子受体2（HER 2）状态的最新信息非常重要，因为表达在疾病过程中可能会发生变化，需要调整抗HER 2治疗。然而，重复活检并不总是可能的。在这项可行性试验中，我们评估了当HER 2状态无法通过标准检查确定时，89 Zr-曲妥珠单抗PET是否可以支持诊断理解并帮助临床决策。此外，还评估了循环肿瘤细胞（CTC）的HER 2状态。如果在标准检查（骨扫描、18 F-FDG PET、CT和活检（如果可行））后疾病HER 2状态仍不清楚，则对患者进行89 Zr-曲妥珠单抗PET。将PET结果和可用肿瘤活检的中心病理学修订报告给转诊医生。之后评价了PET前的CTC HER 2状态，因此未报告。由转诊医生在89 Zr-曲妥珠单抗PET之前、之后即刻和之后≥ 3个月完成诊断理解和治疗决策问卷。入组了20例患者：8例患有两种原发性癌症（HER 2阳性和HER 2阴性BC或BC和非BC），7例患有无法进行活检的转移瘤，4例患有既往HER 2阳性和阴性转移瘤，1例患有HER 2状态不明确的原发性BC。12例患者的89 Zr-曲妥珠单抗PET为阳性，7例为阴性，1例为可疑。在15/20例患者中，89 Zr-曲妥珠单抗PET支持治疗决策。扫描改变了8名患者的治疗，增加了医生的信心，而不影响10名患者的治疗，并提高了医生对18名患者疾病的理解。在10/20例患者中检测到CTC; 6/10例显示HER 2表达。CTC HER 2状态与89 Zr-曲妥珠单抗PET结果或治疗决定无关。当HER 2状态无法通过标准检查确定时，89 Zr-曲妥珠单抗PET支持临床决策。CTC HER 2状态的影响需要进一步探讨。本文的在线版本（10.1007/s 00259 -018-4099-8）包含补充材料，可供授权用户使用。
Up-to-date information on human epidermal growth factor receptor 2 (HER2) status in breast cancer (BC) is important, as expression can vary during the course of the disease, necessitating anti-HER2 therapy adjustments. Repeat biopsies, however, are not always possible. In this feasibility trial we assessed whether 89Zr-trastuzumab PET could support diagnostic understanding and aid clinical decision making, when HER2 status could not be determined by standard work up. Additionally, HER2 status on circulating tumour cells (CTCs) was assessed. 89Zr-trastuzumab PET was performed in patients if disease HER2 status remained unclear after standard work up (bone scan, 18F-FDG PET, CT and if feasible a biopsy). PET result and central pathologic revision of available tumour biopsies were reported to the referring physician. CTC HER2 status prior to PET was evaluated afterwards and therefore not reported. Diagnostic understanding and treatment decision questionnaires were completed by the referring physicians before, directly after and ≥ 3 months after 89Zr-trastuzumab PET. Twenty patients were enrolled: 8 with two primary cancers (HER2-positive and HER2-negative BC or BC and non-BC), 7 with metastases inaccessible for biopsy, 4 with prior HER2-positive and -negative metastases and 1 with primary BC with equivocal HER2 status. 89Zr-trastuzumab PET was positive in 12 patients, negative in 7 and equivocal in 1 patient. In 15/20 patients, 89Zr-trastuzumab PET supported treatment decision. The scan altered treatment of 8 patients, increased physicians’ confidence without affecting treatment in 10, and improved physicians’ disease understanding in 18 patients. In 10/20 patients CTCs were detected; 6/10 showed HER2 expression. CTC HER2 status was not correlated to 89Zr-trastuzumab PET result or treatment decision. 89Zr-trastuzumab PET supports clinical decision making when HER2 status cannot be determined by standard work up. The impact of CTC HER2 status needs to be further explored. The online version of this article (10.1007/s00259-018-4099-8) contains supplementary material, which is available to authorized users.
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影响因子：
158.5
作者：
Cristofanilli, M;Budd, GT;Hayes, DF
通讯作者：
Hayes, DF
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
DOI：
10.1126/science.1235226
发表时间：
2013-09-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Plaks V;Koopman CD;Werb Z
通讯作者：
Werb Z
影响因子：
9.3
作者：
Dijkers, Eli C. F.;Kosterink, Jos G. W.;Lub-de Hooge, Marjolijn N.
通讯作者：
Lub-de Hooge, Marjolijn N.
影响因子：
50.5
作者：
Curigliano, G.;Bagnardi, V.;Goldhirsch, A.
通讯作者：
Goldhirsch, A.