NTRODUCTION: To assess (18)F-2-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography's ((18)F-FDG-PET/CT) potential clinical utility to allow early treatment changes during preoperative chemotherapy (PCT) in patients with early/locally advanced breast cancer (BC). PATIENTS AND METHODS: Sixty newly diagnosed early/locally advanced BC patients received 6-8 cycles of PCT. Optimal pathologic response (pR) was the absence of cancer cells in breast and axillary lymph nodes. All other conditions were defined as pathologic non-response (pNR). (18)F-FDG-PET/CT maximum standardised uptake value (SUV(max)) was measured at baseline and after 2 cycles of PCT. Metabolic response was defined as SUV(max) percentage changes (Δ-SUV) >50% and was compared with pR rates. RESULTS: Thirteen (22%) patients achieved pR; according to immunohistochemistry, 16% of ER-positive/HER2-negative patients, 29% and 27% of HER2-positive and triple negative patients respectively achieved pR. (18)F-FDG-PET/CT showed the highest specificity (38%) and negative predictive value (100%) in ER-positive/HER2-negative patients. In this subgroup, at a median follow-up of 36.6 months, median disease-free survival was still not reached in metabolic responders while it was 37 months in metabolic non-responders (p=0.049). DISCUSSION: Early metabolic non-response was always associated to pNR and poor prognosis in ER-positive/HER2-negative patients. In this subgroup, (18)F-FDG-PET/CT might be useful to select patients who will probably benefit from early therapeutic strategy modifications. Copyright © 2013 Elsevier Ltd. All rights reserved. Comment in Reply to "¹⁸F-2-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in predicting pathologic complete response after neoadjuvant chemotherapy: the early metabolic response is the answer". [Eur J Cancer. 2013] 18F-FDG-PET/CT in predicting pathologic complete response after neoadjuvant chemotherapy: the early metabolic response is the answer.
Zucchini G., Quercia S., Zamagni C., Santini D., Taffurelli M., Fanti S., et al. (2013). Potential utility of early metabolic response by 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography in a selected group of breast cancer patients receiving preoperative chemotherapy. EUROPEAN JOURNAL OF CANCER, 49, 1539-1545 [10.1016/j.ejca.2012.12.024].
Potential utility of early metabolic response by 18F-2-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography in a selected group of breast cancer patients receiving preoperative chemotherapy.
SANTINI, DONATELLA;TAFFURELLI, MARIO;FANTI, STEFANO;
2013
Abstract
NTRODUCTION: To assess (18)F-2-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography's ((18)F-FDG-PET/CT) potential clinical utility to allow early treatment changes during preoperative chemotherapy (PCT) in patients with early/locally advanced breast cancer (BC). PATIENTS AND METHODS: Sixty newly diagnosed early/locally advanced BC patients received 6-8 cycles of PCT. Optimal pathologic response (pR) was the absence of cancer cells in breast and axillary lymph nodes. All other conditions were defined as pathologic non-response (pNR). (18)F-FDG-PET/CT maximum standardised uptake value (SUV(max)) was measured at baseline and after 2 cycles of PCT. Metabolic response was defined as SUV(max) percentage changes (Δ-SUV) >50% and was compared with pR rates. RESULTS: Thirteen (22%) patients achieved pR; according to immunohistochemistry, 16% of ER-positive/HER2-negative patients, 29% and 27% of HER2-positive and triple negative patients respectively achieved pR. (18)F-FDG-PET/CT showed the highest specificity (38%) and negative predictive value (100%) in ER-positive/HER2-negative patients. In this subgroup, at a median follow-up of 36.6 months, median disease-free survival was still not reached in metabolic responders while it was 37 months in metabolic non-responders (p=0.049). DISCUSSION: Early metabolic non-response was always associated to pNR and poor prognosis in ER-positive/HER2-negative patients. In this subgroup, (18)F-FDG-PET/CT might be useful to select patients who will probably benefit from early therapeutic strategy modifications. Copyright © 2013 Elsevier Ltd. All rights reserved. Comment in Reply to "¹⁸F-2-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in predicting pathologic complete response after neoadjuvant chemotherapy: the early metabolic response is the answer". [Eur J Cancer. 2013] 18F-FDG-PET/CT in predicting pathologic complete response after neoadjuvant chemotherapy: the early metabolic response is the answer.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
