Detection of HER2-Positive Metastases in Patients with HER2-Negative Primary Breast Cancer Using 89Zr-Trastuzumab PET/CT.
Detection of HER2-Positive Metastases in Patients with HER2-Negative Primary Breast Cancer Using 89Zr-Trastuzumab PET/CT.
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DOI：
10.2967/jnumed.115.172031
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Carrasquillo JA
中科院分区：
文献类型：
--
作者：
Ulaner GA;Hyman DM;Ross DS;Corben A;Chandarlapaty S;Goldfarb S;McArthur H;Erinjeri JP;Solomon SB;Kolb H;Lyashchenko SK;Lewis JS;Carrasquillo JA
确定人表皮生长因子受体2（HER 2）靶向PET示踪剂成像是否可以检测HER 2阴性原发性乳腺癌患者的HER 2阳性转移。HER 2阴性原发性乳腺癌和远处转移证据的患者入组机构审查委员会（IRB）批准的前瞻性临床试验。对患者原发性乳腺癌的存档病理学进行了重新检测，以确认HER 2阴性疾病。确诊为HER 2阴性原发性乳腺癌的患者接受了89 Zr-曲妥珠单抗PET/CT，以筛查89 Zr-曲妥珠单抗转移。通过PET/CT对89 Zr-曲妥珠单抗敏感的转移瘤进行活检和病理学检查，以确定HER 2状态。经病理学证实为HER 2阳性转移的患者随后接受了方案外HER 2靶向治疗，以评价治疗缓解。入组了9例患者，所有患者均进行了病理复检，证实为HER 2阴性原发性乳腺癌。5个在89 Zr-曲妥珠单抗PET/CT上显示可疑病灶。在这5个可疑病灶中，2个有活检证实的HER 2阳性转移，并继续从HER 2靶向治疗中获益。5例可疑病灶患者中有3例进行了活检，无HER 2阳性疾病证据，被认为是假阳性假阳性89 Zr-曲妥珠单抗PET病灶。在这项概念验证研究中，我们证明了89 Zr-曲妥珠单抗PET/CT可检测到HER 2阳性原发性乳腺癌患者的非可疑HER 2阳性转移。虽然这些只是小样本的初步结果，但它证明了HER 2靶向成像可以识别HER 2靶向治疗的其他候选者。临床应用将需要更特异性的HER 2靶向药物。
To determine if imaging with a human epidermal growth factor receptor 2 (HER2)-targeting PET tracer can detect HER2-positive metastases in patients with HER2-negative primary breast cancer. Patients with HER2-negative primary breast cancer and evidence of distant metastases were enrolled in an Institutional Review Board (IRB)-approved prospective clinical trial. Archived pathology from the patient’s primary breast cancer was retested to confirm HER2-negative disease. Patients with confirmed HER2-negative primary breast cancer underwent 89Zr-trastuzumab PET/CT to screen for 89Zr-trastuzumab metastases. Metastases avid for 89Zr-trastuzumab by PET/CT were biopsied and pathologically examined to define HER2 status. Patients with pathologically proven HER2-positive metastases subsequently received off-protocol HER2 targeted therapy to evaluate treatment response. Nine patients were enrolled, all of whom had pathologic retesting that confirmed HER2-negative primary breast cancer. Five demonstrated suspicious foci on 89Zr-trastuzumab PET/CT. Of these five with suspicious foci, two had biopsy proven HER2-positive metastases and went on to benefit from HER2 targeted therapy. Three of the five patients with suspicious foci had biopsy without evidence of HER2-positive disease, and were considered false positive false positive 89Zr-trastuzumab PET foci. In this proof-of-concept study, we demonstrate that 89Zr-trastuzmab PET/CT detects unsuspected HER2-positive metastases in patients with HER2-negtive primary breast cancer. While these are only initial results in a small sample, it is a proof of concept that HER2-targeted imaging can identify additional candidates for HER2-targeted therapy. More specific HER2-targeting agents will be needed for clinical use.
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DOI：
10.1186/bcr2645
发表时间：
2010
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Hoefnagel LD;van de Vijver MJ;van Slooten HJ;Wesseling P;Wesseling J;Westenend PJ;Bart J;Seldenrijk CA;Nagtegaal ID;Oudejans J;van der Valk P;van der Groep P;de Vries EG;van der Wall E;van Diest PJ
通讯作者：
van Diest PJ
影响因子：
3.1
作者：
Abou DS;Ku T;Smith-Jones PM
通讯作者：
Smith-Jones PM
影响因子：
45.3
作者：
Niikura, Naoki;Liu, Jun;Ueno, Naoto T.
通讯作者：
Ueno, Naoto T.
影响因子：
50.3
作者：
McGranahan, Nicholas;Swanton, Charles
通讯作者：
Swanton, Charles
影响因子：
9.3
作者：
Keyaerts, Marleen;Xavier, Catarina;Lahoutte, Tony
通讯作者：
Lahoutte, Tony