Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer
Abstract Background To compare the value of interim 18F-FLT-PET and 18F-FDG-PET for predicting treatment outcomes in patients with metastatic breast cancer after salvage therapy. Methods Patients with metastatic breast cancer received PET/CT using 18F-FLT and 18F-FDG at baseline, after the 1st and 2...
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doaj-93a77a2848fd4945aac14dbbd767a5be2021-08-15T11:35:29ZengBMCBMC Cancer1471-24072021-08-0121111310.1186/s12885-021-08649-zProspective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancerTzu-Pei Su0Jen-Seng Huang1Pei-Hung Chang2Kar-Wai Lui3Jason Chia-Hsun Hsieh4Shu-Hang Ng5Sheng-Chieh Chan6Department of Nuclear Medicine, Keelung Chang Gung Memorial HospitalDivision of Hematology/Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial HospitalDivision of Hematology/Oncology, Department of Internal Medicine, Keelung Chang Gung Memorial HospitalDepartment of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of MedicineDivision of Hematology/Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital and Chang Gung University College of MedicineDepartment of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationAbstract Background To compare the value of interim 18F-FLT-PET and 18F-FDG-PET for predicting treatment outcomes in patients with metastatic breast cancer after salvage therapy. Methods Patients with metastatic breast cancer received PET/CT using 18F-FLT and 18F-FDG at baseline, after the 1st and 2nd cycle of systemic chemotherapy. The clinical response was classified according to Response Evaluation Criteria in Solid Tumors 1.1 based on contrast-enhanced CT after 3 months of systemic chemotherapy. The metabolic response on PET was assessed according to European Organization for Research and Treatment of Cancer criteria or PET Response Criteria in Solid Tumors (PERCIST) and was correlated to the clinical response, overall survival (OS), and progression-free survival (PFS). Results Twenty-five patients entered final analysis. On 18F-FDG-PET, clinical responders after 2 chemotherapy cycles (post-2c) had a significantly greater reduction of maximal standardized uptake value (SUV) and the peak SUV corrected for lean body mass (SULpeak) of the tumor than non-responders (P = 0.030 and 0.003). Metabolic response determined by PERCIST on post-2c 18F-FDG-PET showed a high area under the receiver operating characteristics curve of 0.801 in predicting clinical response (P = 0.011). Patients who were metabolic responders by PERCIST on post-2c 18F-FDG-PET had a significantly longer PFS (53.8% vs. 16.7%, P = 0.014) and OS (100% vs. 47.6%, P = 0.046) than non-responders. Survival differences between responders and non-responders in the interim 18F-FLT-PET were not significant. Conclusions 18F-FLT-PET failed to show an advantage over 18F-FDG-PET in predicting the treatment response and survival in patients with metastatic breast cancer. Assessment of treatment outcome by interim 18F-FDG-PET may aid treatment. Trial registration The study was retrospectively registered on 02/06/2020 on Clinicaltrials.gov (identifier NCT04411966 ).https://doi.org/10.1186/s12885-021-08649-zBreast cancerPositron-emission tomography18F-FDG18F-FLTPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tzu-Pei Su Jen-Seng Huang Pei-Hung Chang Kar-Wai Lui Jason Chia-Hsun Hsieh Shu-Hang Ng Sheng-Chieh Chan |
spellingShingle |
Tzu-Pei Su Jen-Seng Huang Pei-Hung Chang Kar-Wai Lui Jason Chia-Hsun Hsieh Shu-Hang Ng Sheng-Chieh Chan Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer BMC Cancer Breast cancer Positron-emission tomography 18F-FDG 18F-FLT Prognosis |
author_facet |
Tzu-Pei Su Jen-Seng Huang Pei-Hung Chang Kar-Wai Lui Jason Chia-Hsun Hsieh Shu-Hang Ng Sheng-Chieh Chan |
author_sort |
Tzu-Pei Su |
title |
Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer |
title_short |
Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer |
title_full |
Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer |
title_fullStr |
Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer |
title_full_unstemmed |
Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer |
title_sort |
prospective comparison of early interim 18f-fdg-pet with 18f-flt-pet for predicting treatment response and survival in metastatic breast cancer |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2021-08-01 |
description |
Abstract Background To compare the value of interim 18F-FLT-PET and 18F-FDG-PET for predicting treatment outcomes in patients with metastatic breast cancer after salvage therapy. Methods Patients with metastatic breast cancer received PET/CT using 18F-FLT and 18F-FDG at baseline, after the 1st and 2nd cycle of systemic chemotherapy. The clinical response was classified according to Response Evaluation Criteria in Solid Tumors 1.1 based on contrast-enhanced CT after 3 months of systemic chemotherapy. The metabolic response on PET was assessed according to European Organization for Research and Treatment of Cancer criteria or PET Response Criteria in Solid Tumors (PERCIST) and was correlated to the clinical response, overall survival (OS), and progression-free survival (PFS). Results Twenty-five patients entered final analysis. On 18F-FDG-PET, clinical responders after 2 chemotherapy cycles (post-2c) had a significantly greater reduction of maximal standardized uptake value (SUV) and the peak SUV corrected for lean body mass (SULpeak) of the tumor than non-responders (P = 0.030 and 0.003). Metabolic response determined by PERCIST on post-2c 18F-FDG-PET showed a high area under the receiver operating characteristics curve of 0.801 in predicting clinical response (P = 0.011). Patients who were metabolic responders by PERCIST on post-2c 18F-FDG-PET had a significantly longer PFS (53.8% vs. 16.7%, P = 0.014) and OS (100% vs. 47.6%, P = 0.046) than non-responders. Survival differences between responders and non-responders in the interim 18F-FLT-PET were not significant. Conclusions 18F-FLT-PET failed to show an advantage over 18F-FDG-PET in predicting the treatment response and survival in patients with metastatic breast cancer. Assessment of treatment outcome by interim 18F-FDG-PET may aid treatment. Trial registration The study was retrospectively registered on 02/06/2020 on Clinicaltrials.gov (identifier NCT04411966 ). |
topic |
Breast cancer Positron-emission tomography 18F-FDG 18F-FLT Prognosis |
url |
https://doi.org/10.1186/s12885-021-08649-z |
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