18F-fluorodeoxyglucose (FDG) PET or 18F-fluorothymidine (FLT) PET to assess early response to aromatase inhibitors (AI) in women with ER+ operable breast cancer in a window-of-opportunity study

Breast Cancer Research

Kenneth A. Krohn¹  Jeanne M. Link¹  Alena Novakova-Jiresova²  Robert K. Doot³  David A. Mankoff³  Mark Muzi⁴  Darrin W. Byrd⁴  Paul E. Kinahan⁴  Perrin E. Romine⁵  Hannah M. Linden⁵  Jennifer M. Specht⁵  Lanell M. Peterson⁵  Brenda F. Kurland⁶ 

[1] Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA;Department of Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic;Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA;Department of Radiology, University of Washington, Seattle, WA, USA;Division of Medical Oncology, University of Washington/Seattle Cancer Care Alliance, 1144 Eastlake (Mail Stop LG-200), 98109-1023, Seattle, WA, USA;University of Pittsburgh, Pittsburgh, PA, USA;

关键词: FDG-PET;    FLT-PET;    Ki-67;    ER+ breast cancer;    Aromatase inhibitors;   

DOI  :  10.1186/s13058-021-01464-1

来源: Springer

【 摘 要 】

PurposeThis study evaluated the ability of 18F-Fluorodeoxyglucose (FDG) and 18F-Fluorothymidine (FLT) imaging with positron emission tomography (PET) to measure early response to endocrine therapy from baseline to just prior to surgical resection in estrogen receptor positive (ER+) breast tumors.MethodsIn two separate studies, women with early stage ER+ breast cancer underwent either paired FDG-PET (n = 22) or FLT-PET (n = 27) scans prior to endocrine therapy and again in the pre-operative setting. Tissue samples for Ki-67 were taken for all patients both prior to treatment and at the time of surgery.ResultsFDG maximum standardized uptake value (SUVmax) declined in 19 of 22 lesions (mean 17% (range −45 to 28%)). FLT SUVmax declined in 24 of 27 lesions (mean 26% (range −77 to 7%)). The Ki-67 index declined in both studies, from pre-therapy (mean 23% (range 1 to 73%)) to surgery [mean 8% (range < 1 to 41%)]. Pre- and post-therapy PET measures showed strong rank-order agreement with Ki-67 percentages for both tracers; however, the percent change in FDG or FLT SUVmax did not demonstrate a strong correlation with Ki-67 index change or Ki-67 at time of surgery.ConclusionsA window-of-opportunity approach using PET imaging to assess early response of breast cancer therapy is feasible. FDG and FLT-PET imaging following a short course of neoadjuvant endocrine therapy demonstrated measurable changes in SUVmax in early stage ER+ positive breast cancers. The percentage change in FDG and FLT-PET uptake did not correlate with changes in Ki-67; post-therapy SUVmax for both tracers was significantly associated with post-therapy Ki-67, an established predictor of endocrine therapy response.

【 授权许可】

CC BY