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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
18
F-FDG PET/CT for early prediction of response to neoadjuvant lapatinib, trastuzumab, and their combination in HER2-positive breast cancer: Results from neo-ALTTO
Journal of Nuclear Medicine, Volume 54, No. 11, Year 2013
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Description
Molecular imaging receives increased attention for selecting patients who will benefit from targeted anticancer therapies. Neo-ALTTO (Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) enrolled 455 women with invasive human epidermal growth factor receptor 2 (HER2)-positive breast cancer and compared rates of pathologic complete response (pCR) to neoadjuvant lapatinib, trastuzumab, and their combination. Each anti-HER2 therapy was given alone for 6 wk, followed by 12 wk of the same therapy plus weekly paclitaxel. The early metabolic effects of the anti-HER2 therapies on the primary tumors and their predictive values for pCR were assessed in a subset of patients. Methods: Eighty-six patients underwent 18F-FDG PET/CT at baseline and weeks 2 and 6 of anti-HER2 treatment. An imaging core laboratory provided central validation, and 2 independent reviewers, masked to assigned treatment arm and clinical outcomes, performed consensus 18F-FDG PET/CT readings. Maximum standardized uptake value (SUVmax) reductions from baseline were used to measure metabolic response. Results: Seventy-seven of the 86 enrolled patients presented an evaluable baseline 18F-FDG PET/CT scan; of these, 68 and 66 were evaluable at weeks 2 and 6, respectively. Metabolic responses in the primary tumors were evident after 2 wk of targeted therapy and correlated highly with metabolic responses at week 6 (R2 5 0.81). pCRs were associated with greater SUVmax reductions at both time points. Mean SUVmax reductions for pCR and non-pCR, respectively, were 54.3% versus 32.8% at week 2 (P 5 0.02) and 61.5% versus 34.1% at week 6 (P 5 0.02). 18F-FDG PET/CT metabolic response rates at weeks 2 and 6 were 71.6% and 60%, respectively using European Organization for Research and Treatment of Cancer criteria; pCR rates were twice as high for 18F-FDG PET/CT responders than nonresponders (week 2: 42% vs. 21%, P 5 0.12; week 6: 44% vs. 19%, P 5 0.05). Conclusion: Early metabolic assessment using 18F-FDG PET/CT can identify patients with an increased likelihood of pCR after neoadjuvant trastuzumab, lapatinib, or their combination when given with chemotherapy. © 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
Authors & Co-Authors
Gebhart, Géraldine
Unknown Affiliation
Gámez, Cristina
Unknown Affiliation
Holmes, Eileen
Unknown Affiliation
Robles, Javier
Unknown Affiliation
Garcia, Camilo
Unknown Affiliation
Cortés, Montserrat
Unknown Affiliation
de Azambuja, Evandro
Unknown Affiliation
Fauria, Karine
Unknown Affiliation
Van Dooren, Veerle
Unknown Affiliation
Aktan, Gursel
Unknown Affiliation
Coccia-Portugal, Maria Antonia
Unknown Affiliation
Kim, Sung-bae
Unknown Affiliation
Vuylsteke, Peter
Unknown Affiliation
Curé, H.
Unknown Affiliation
Eidtmann, Holger
Unknown Affiliation
Baselga, José M.
Unknown Affiliation
Piccart-Gebhart, Martine J.
Unknown Affiliation
Flamen, Patrick
Unknown Affiliation
Di Cosimo, Serena
Unknown Affiliation
Statistics
Citations: 137
Authors: 19
Affiliations: 14
Identifiers
Doi:
10.2967/jnumed.112.119271
ISSN:
01615505
Research Areas
Cancer
Health System And Policy
Noncommunicable Diseases
Participants Gender
Female