Early metabolic response using FDG PET/CT and molecular phenotypes of breast cancer treated with neoadjuvant chemotherapy.

Abstract

BACKGROUND:

This study was aimed 1) to investigate the predictive value of FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) for histopathologic response and 2) to explore the results of FDG PET/CT by molecular phenotypes of breast cancer patients who received neoadjuvant chemotherapy.

METHODS:

Seventy-eight stage II or III breast cancer patients who received neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this study. FDG PET/CTs were acquired before chemotherapy and after the first cycle of chemotherapy for evaluating early metabolic response.

RESULTS:

The mean pre- and post-chemotherapy standard uptake value (SUV) were 7.5 and 3.9, respectively. The early metabolic response provided by FDG PET/CT after one cycle of neoadjuvant chemotherapy was correlated with the histopathologic response after completion of neoadjuvant chemotherapy (P = 0.002). Sensitivity and negative predictive value were 85.7% and 95.1%, respectively. The estrogen receptor negative phenotype had a higher pre-chemotherapy SUV (8.6 vs. 6.4, P = 0.047) and percent change in SUV (48% vs. 30%, P = 0.038). In triple negative breast cancer (TNBC), the pre-chemotherapy SUV was higher than in non-TNBC (9.8 vs. 6.4, P = 0.008).

CONCLUSIONS:

The early metabolic response using FDG PET/CT could have a predictive value for the assessment of histopathologic non-response of stage II/III breast cancer treated with neoadjuvant chemotherapy. Our findings suggest that the initial SUV and the decline in SUV differed based on the molecular phenotype.

• Authors: Bhumsuk Keam, Seock-Ah Im, Youngil Koh, Sae-Won Han, Do-Youn Oh, Nariya Cho, Jee Hyun Kim, Wonshik Han, Keon Wook Kang, Woo Kyung Moon, Tae-You Kim, In Ae Park, Dong-Young Noh, June-Key Chung, Yung-Jue Bang
• Journal: BMC cancer (BMC Cancer) Vol. 11 Pg. 452 (Oct 20 2011) ISSN: 1471-2407 [Electronic] England
• PMID: 22011459 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Biomarkers, Tumor
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Biomarkers, Tumor (metabolism)
• Breast Neoplasms (diagnostic imaging, drug therapy, metabolism)
• Female
• Fluorodeoxyglucose F18
• Humans
• Middle Aged
• Multimodal Imaging
• Neoadjuvant Therapy
• Neoplasm Staging
• Phenotype
• Positron-Emission Tomography
• Tomography, X-Ray Computed