David Groheux1, Elif Hindié2, Sylvie Giacchetti3, Anne-Sophie Hamy4, Frederique Berger5, Pascal Merlet6, Anne de Roquancourt7, Patricia de Cremoux8, Michel Marty9, Mathieu Hatt10, Marc Espié3. 1. Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; B2T, Doctoral School, IUH, University of Paris VII, France. Electronic address: dgroheux@yahoo.fr. 2. Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, France. 3. Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris, France. 4. Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris, France; Department of Biostatistics, Institut Curie, Paris, France. 5. Department of Biostatistics, Institut Curie, Paris, France. 6. Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; B2T, Doctoral School, IUH, University of Paris VII, France. 7. Department of Pathology, Saint-Louis Hospital, Paris, France. 8. Department of Biochemistry, Saint-Louis Hospital, Paris, France. 9. Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris, France; Centre for Therapeutic Innovation, Saint Louis Hospital, Paris, France. 10. INSERM, UMR 1101 LaTIM, Brest, France.
Abstract
BACKGROUND: In patients with triple-negative breast cancer (TNBC), pathology complete response (pCR) to neoadjuvant chemotherapy (NAC) is associated with improved prognosis. This prospective study was designed and powered to investigate the ability of interim (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)FDG-PET/CT) to predict pathology outcomes to NAC early during treatment. PATIENTS AND METHODS: Consecutive TNBC women underwent (18)FDG-PET/CT at baseline and after two courses of NAC. Maximum standardised uptake value (SUV(max)) in the primary tumour and lymph nodes at each examination and the evolution (ΔSUV(max)) between the two scans were measured. NAC was continued irrespective of PET results. Correlations between PET parameters and pathology response, and between PET parameters and event-free survival (EFS), were examined. RESULTS: Fifty patients without distant metastases were enroled. At completion of NAC, surgery showed pCR in 19 patients, while 31 had residual tumour. Mean follow-up was 30.3 months. Thirteen patients, all with residual tumour, experienced relapse. Of all assessed clinical, biological and PET parameters, ΔSUV(max) in the primary tumour was the most predictive of pathology results (p<0.0001; Mann-Whitney-U test) and EFS (p=0.02; log rank test). A threshold of 42% decrease in SUV was identified because it offered the best accuracy in predicting EFS. There were 32 metabolic responders (⩾ 42% decrease in SUV(max)) and 18 non-responders. Within responders, the pCR rate was 59% and the 3-year EFS 77.5%. In non-responders, the pCR rate was 0% and the 3-year EFS 47.1%. CONCLUSION: Interim (18)FDG can early predict the inefficacy of NAC in TNBC patients. It shows promise as a potential contributory biomarker in these patients.
BACKGROUND: In patients with triple-negative breast cancer (TNBC), pathology complete response (pCR) to neoadjuvant chemotherapy (NAC) is associated with improved prognosis. This prospective study was designed and powered to investigate the ability of interim (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)FDG-PET/CT) to predict pathology outcomes to NAC early during treatment. PATIENTS AND METHODS: Consecutive TNBC women underwent (18)FDG-PET/CT at baseline and after two courses of NAC. Maximum standardised uptake value (SUV(max)) in the primary tumour and lymph nodes at each examination and the evolution (ΔSUV(max)) between the two scans were measured. NAC was continued irrespective of PET results. Correlations between PET parameters and pathology response, and between PET parameters and event-free survival (EFS), were examined. RESULTS: Fifty patients without distant metastases were enroled. At completion of NAC, surgery showed pCR in 19 patients, while 31 had residual tumour. Mean follow-up was 30.3 months. Thirteen patients, all with residual tumour, experienced relapse. Of all assessed clinical, biological and PET parameters, ΔSUV(max) in the primary tumour was the most predictive of pathology results (p<0.0001; Mann-Whitney-U test) and EFS (p=0.02; log rank test). A threshold of 42% decrease in SUV was identified because it offered the best accuracy in predicting EFS. There were 32 metabolic responders (⩾ 42% decrease in SUV(max)) and 18 non-responders. Within responders, the pCR rate was 59% and the 3-year EFS 77.5%. In non-responders, the pCR rate was 0% and the 3-year EFS 47.1%. CONCLUSION: Interim (18)FDG can early predict the inefficacy of NAC in TNBC patients. It shows promise as a potential contributory biomarker in these patients.
Authors: Lale Kostakoglu; Fenghai Duan; Michael O Idowu; Paul R Jolles; Harry D Bear; Mark Muzi; Jean Cormack; John P Muzi; Daniel A Pryma; Jennifer M Specht; Linda Hovanessian-Larsen; John Miliziano; Sharon Mallett; Anthony F Shields; David A Mankoff Journal: J Nucl Med Date: 2015-09-10 Impact factor: 10.057
Authors: D Groheux; S Giacchetti; M Delord; A de Roquancourt; P Merlet; A S Hamy; M Espié; E Hindié Journal: Eur J Nucl Med Mol Imaging Date: 2014-11-29 Impact factor: 9.236
Authors: David Groheux; L Biard; J Lehmann-Che; L Teixeira; F A Bouhidel; B Poirot; P Bertheau; P Merlet; M Espié; M Resche-Rigon; C Sotiriou; P de Cremoux Journal: Eur J Nucl Med Mol Imaging Date: 2018-04-04 Impact factor: 9.236