Amy R Deipolyi1, Christopher C Riedl2, Jacqueline Bromberg3, Sarat Chandarlapaty3, Christopher A Klebanoff4, Constantinos T Sofocleous5, Hooman Yarmohammadi5, Lynn A Brody5, F Edward Boas5, Etay Ziv5. 1. Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave., H118-A, New York, NY 10065; Weill Cornell Medical College, New York, New York. Electronic address: deipolya@mskcc.org. 2. Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave., H118-A, New York, NY 10065; Weill Cornell Medical College, New York, New York. 3. Department of Radiology, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave., H118-A, New York, NY 10065; Weill Cornell Medical College, New York, New York. 4. Center for Cell Engineering and Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Ave., H118-A, New York, NY 10065; Weill Cornell Medical College, New York, New York. 5. Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave., H118-A, New York, NY 10065; Weill Cornell Medical College, New York, New York.
Abstract
PURPOSE: To describe imaging response and survival after radioembolization for metastatic breast cancer and to delineate genetic predictors of imaging responses and outcomes. MATERIALS AND METHODS: This retrospective study included 31 women (average age, 52 y) with liver metastasis from invasive ductal carcinoma who underwent resin and glass radioembolization (average cumulative dose, 2.0 GBq ± 1.8) between January 2011 and September 2017 after receiving ≥ 3 lines of chemotherapy. Twenty-four underwent genetic profiling with MSK-IMPACT or Sequenom; 26 had positron-emission tomography (PET)/CT imaging before and after treatment. Survival after the first radioembolization and 2-4-month PET/CT imaging response were assessed. Laboratory and imaging features were assessed to determine variables predictive of outcomes. Unpaired Student t tests and Fisher exact tests were used to compare responders and nonresponders categorized by changes in fluorodeoxyglucose avidity. Kaplan-Meier survival analysis was used to determine the impact of predictors on survival after radioembolization. RESULTS: Median survival after radioembolization was 11 months (range, 1-49 mo). Most patients (18 of 26; 69%) had complete or partial response based on changes in fluorodeoxyglucose avidity. Imaging response was associated with longer survival (P = .005). Whereas 100% of patients with PI3K pathway mutations showed an imaging response, only 45% of wild-type patients showed a response (P = .01). Median survival did not differ between PI3K pathway wild-type (10.9 mo) and mutant (undefined) patients (P = .50). CONCLUSIONS: These preliminary data suggest that genomic profiling may predict which patients with metastatic breast cancer benefit most from radioembolization. PI3K pathway mutations are associated with improved imaging response, which is associated with longer survival.
PURPOSE: To describe imaging response and survival after radioembolization for metastatic breast cancer and to delineate genetic predictors of imaging responses and outcomes. MATERIALS AND METHODS: This retrospective study included 31 women (average age, 52 y) with liver metastasis from invasive ductal carcinoma who underwent resin and glass radioembolization (average cumulative dose, 2.0 GBq ± 1.8) between January 2011 and September 2017 after receiving ≥ 3 lines of chemotherapy. Twenty-four underwent genetic profiling with MSK-IMPACT or Sequenom; 26 had positron-emission tomography (PET)/CT imaging before and after treatment. Survival after the first radioembolization and 2-4-month PET/CT imaging response were assessed. Laboratory and imaging features were assessed to determine variables predictive of outcomes. Unpaired Student t tests and Fisher exact tests were used to compare responders and nonresponders categorized by changes in fluorodeoxyglucose avidity. Kaplan-Meier survival analysis was used to determine the impact of predictors on survival after radioembolization. RESULTS: Median survival after radioembolization was 11 months (range, 1-49 mo). Most patients (18 of 26; 69%) had complete or partial response based on changes in fluorodeoxyglucose avidity. Imaging response was associated with longer survival (P = .005). Whereas 100% of patients with PI3K pathway mutations showed an imaging response, only 45% of wild-type patients showed a response (P = .01). Median survival did not differ between PI3K pathway wild-type (10.9 mo) and mutant (undefined) patients (P = .50). CONCLUSIONS: These preliminary data suggest that genomic profiling may predict which patients with metastatic breast cancer benefit most from radioembolization. PI3K pathway mutations are associated with improved imaging response, which is associated with longer survival.
Authors: B M Aarts; F M Gómez Muñoz; H Wildiers; V O Dezentjé; T R Baetens; W Schats; M Lopez-Yurda; R C Dresen; B J de Wit-van der Veen; C M Deroose; G Maleux; R G H Beets-Tan; E G Klompenhouwer Journal: Cardiovasc Intervent Radiol Date: 2021-07-28 Impact factor: 2.740
Authors: Elie Barakat; Andras Bibok; Anupam Rishi; Altan Ahmed; Jessica M Frakes; Sarah E Hoffe; Avan J Armaghani; Aixa E Soyano; Ricardo L B Costa; Ghassan El-Haddad; Junsung Choi; Bela Kis Journal: Adv Radiat Oncol Date: 2021-10-29
Authors: Fourat Ridouani; Mohamed M Soliman; Ryan W England; Meier Hsu; Chaya S Moskowitz; Raphael Doustaly; Constantinos T Sofocleous; F Edward Boas; Hooman Yarmohammadi; Amy R Deipolyi Journal: Eur J Radiol Date: 2021-01-12 Impact factor: 3.528