Prognostic value of metabolic response in breast cancer patients receiving neoadjuvant chemotherapy

BMC Cancer

Research Article

Ingrid S Gribbestad¹  Guro F Giskeødegård¹  Maria D Cao²  Steinar Lundgren³  Tone F Bathen⁴  Beathe Sitter⁴  Anna Bofin⁵  Per E Lønning⁶ 

[1] Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), 7489, Trondheim, Norway;Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), 7489, Trondheim, Norway;Department of Circulation and Medical Imaging, The Faculty of Medicine, NTNU, MTFS, Postboks 8905, N-7489, Trondheim, Norway;Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), 7489, Trondheim, Norway;Department of Oncology, St. Olavs Hospital, University Hospital of Trondheim, 7006, Trondheim, Norway;Department of Cancer Research and Molecular Medicine, NTNU, 7489, Trondheim, Norway;Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), 7489, Trondheim, Norway;St Olavs University Hospital, Trondheim, Norway;Department of Laboratory Medicine, Children's and Women's Health, NTNU, 7489, Trondheim, Norway;Department of Oncology, Haukeland University Hospital, 5021, Bergen, Norway;Section of Oncology, Institute of medicine, University of Bergen, 5020, Bergen, Norway;

关键词: Breast Cancer Survival;    Metabolic Response;    Partial Little Square Discriminant Analysis;    Partial Little Square Discriminant Analysis Model;    Glycine Level;   

DOI  :  10.1186/1471-2407-12-39

 received in 2011-09-20, accepted in 2012-01-25,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundToday's clinical diagnostic tools are insufficient for giving accurate prognosis to breast cancer patients. The aim of our study was to examine the tumor metabolic changes in patients with locally advanced breast cancer caused by neoadjuvant chemotherapy (NAC), relating these changes to clinical treatment response and long-term survival.MethodsPatients (n = 89) participating in a randomized open-label multicenter study were allocated to receive either NAC as epirubicin or paclitaxel monotherapy. Biopsies were excised pre- and post-treatment, and analyzed by high resolution magic angle spinning magnetic resonance spectroscopy (HR MAS MRS). The metabolite profiles were examined by paired and unpaired multivariate methods and findings of important metabolites were confirmed by spectral integration of the metabolite peaks.ResultsAll patients had a significant metabolic response to NAC, and pre- and post-treatment spectra could be discriminated with 87.9%/68.9% classification accuracy by paired/unpaired partial least squares discriminant analysis (PLS-DA) (p < 0.001). Similar metabolic responses were observed for the two chemotherapeutic agents. The metabolic responses were related to patient outcome. Non-survivors (< 5 years) had increased tumor levels of lactate (p = 0.004) after treatment, while survivors (≥ 5 years) experienced a decrease in the levels of glycine (p = 0.047) and choline-containing compounds (p ≤ 0.013) and an increase in glucose (p = 0.002) levels. The metabolic responses were not related to clinical treatment response.ConclusionsThe differences in tumor metabolic response to NAC were associated with breast cancer survival, but not to clinical response. Monitoring metabolic responses to NAC by HR MAS MRS may provide information about tumor biology related to individual prognosis.

【 授权许可】

CC BY   
© Cao et al; licensee BioMed Central Ltd. 2012