Prediction of chemotherapeutic response by Technetium 99m--MIBI scintigraphy in breast carcinoma patients.

Abstract

BACKGROUND:

Significance of Technetium 99m ((99m)Tc)-MIBI scintigraphy in the prediction of response to anthracylines and taxanes (both are substrates for P-glycoprotein [P-gp]) as well as relation between (99m)Tc-MIBI uptake and P-gp or MDR1 mRNA expression in tumors were studied in patients with breast carcinoma.

METHODS:

Forty-six female patients with locally advanced (n = 15) or metastatic (n = 31) breast carcinoma were recruited in this study. Before chemotherapy (epirubicin and cyclophosphamide [n = 20] or decetaxel [n = 26]), (99m)Tc-MIBI scintigraphy was performed to obtain the T/N (tumor to normal tissue) ratios of (99m)Tc-MIBI uptake at 10 minutes (T/N[e]) and at 180 minutes (T/N[d]) after the (99m)Tc-MIBI injection. Expression of MDR1 mRNA and P-gp in tumors (n = 32) were determined by a quantitative real-time polymerase chain reaction and immunohistochemistry, respectively.

RESULTS:

Clinical significance of T/N(e) and T/N(d) ratios in the prediction of chemotherapeutic response was evaluated using the arbitrary cutoff values of 3.0 for T/N(e) ratios and 2.0 for T/N(d) ratios. Positive predictive value, negative predictive value, and diagnostic accuracy of T/N(d) ratios (81.0%, 96.0%, and 89.1%, respectively) were higher, although statistically not significant, than those of T/N(e) ratios (73.3%, 77.4%, and 76.1%, respectively), and these values were not affected by type of chemotherapy. MDR1 mRNA levels were not significantly different between the lesions with high (> or = 2.0) and low (< 2.0) T/N(d) ratios, but P-gp expression was significantly (P < 0.01) higher in the lesions with low T/N(d) ratios than in those with high T/N(d) ratios.

CONCLUSIONS:

T/N(d) ratios determined by (99m)Tc-MIBI scintigraphy are useful in the prediction of response to chemotherapy with epirubicin and cyclophosphamide or docetaxel as well as in the in vivo evaluation of P-gp expression status in tumors in patients with locally advanced or recurrent breast carcinoma.

• Authors: Y Takamura, Y Miyoshi, T Taguchi, S Noguchi
• Journal: Cancer (Cancer) Vol. 92 Issue 2 Pg. 232-9 (Jul 15 2001) ISSN: 0008-543X [Print] United States
• PMID: 11466674 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright 2001 American Cancer Society.

Chemical References

• ATP Binding Cassette Transporter, Subfamily B
• ATP Binding Cassette Transporter, Subfamily B, Member 1
• Antibiotics, Antineoplastic
• Bridged-Ring Compounds
• RNA, Messenger
• Radiopharmaceuticals
• Taxoids
• taxane
• Technetium Tc 99m Sestamibi

Topics

• ATP Binding Cassette Transporter, Subfamily B (biosynthesis)
• ATP Binding Cassette Transporter, Subfamily B, Member 1 (biosynthesis)
• Adult
• Aged
• Antibiotics, Antineoplastic (pharmacology, therapeutic use)
• Breast Neoplasms (diagnostic imaging, drug therapy)
• Bridged-Ring Compounds (pharmacology, therapeutic use)
• Carcinoma (diagnostic imaging, drug therapy)
• Female
• Genes, MDR (genetics)
• Humans
• Middle Aged
• Polymerase Chain Reaction
• Predictive Value of Tests
• RNA, Messenger (biosynthesis)
• Radionuclide Imaging
• Radiopharmaceuticals (pharmacokinetics)
• Taxoids
• Technetium Tc 99m Sestamibi (pharmacokinetics)
• Treatment Outcome