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Poster lunch

1018 - Impact of apparent diffusion coefficient for the prediction of responses in patients with breast cancer treated with neoadjuvant chemotherapy (77P)

Date

18 Nov 2017

Session

Poster lunch

Presenters

Yutaka Mizuno

Citation

Annals of Oncology (2017) 28 (suppl_10): x16-x24. 10.1093/annonc/mdx655

Authors

Y. Mizuno1, M. Shizuku1, K. Nakamura2, T. Mori1

Author affiliations

  • 1 Breast Surgery, Yokkaichi Municipal Hospital, 510-8567 - Yokkaichi, Mie/JP
  • 2 Imaging And Diagnosis, Syutaikai Hospital, 510-0823 - Yokkaichi, Mie/JP
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Resources

Abstract 1018

Background

Neoadjuvant chemotherapy (NAC) results in a pathologic complete response (pCR), which has been shown to be associated with disease-free survival and overall survival. The apparent diffusion coefficient (ADC) indicates the stability of water molecules, and the ADC has been used to predict the response of solid tumors to chemotherapy. We therefore evaluated the ability of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) to help predict pCR in patients with breast cancer treated with NAC.

Methods

From August 2013 to July 2016, 39 patients (mean age, 53 years; age range, 31–72 years) were treated with the nanoparticle albumin-bound paclitaxel (nab-PTX) (260 mg/m2; q3w for 4 cycles) ± concurrent trastuzumab (8mg, 6mg/Kg; q3w for 4 cycles) followed by the FEC100 (5-fluorouracil/epirubicin/cyclophosphamide, 500/100/500 mg/m2; q3w for 4 cycles). pCR was defined as the absence of any residual invasive cancer or ductal carcinoma in situ. Radiologic complete response (rCR) was defined as the absence of tumor enhancement. The ADC ratio (post FEC ADC/pre nab-PTX ADC) was calculated.

Results

Tumor phenotypes were found to be triple negative (TN) (n = 20) and human epidermal growth factor receptor 2 (HER2) positive (n = 19). pCR was achieved in 21 patients [54%]. rCR was observed in 17 patients [44%] . The mean pre nab-PTX ADC and ADC ratios were not associated with pCR in either phenotype (p = 0.57, p = 0.379 for TN disease; and p = 0.238, p = 0.168 for HER2-positive disease). By using receiver operating characteristic (ROC) analysis with the ADC ratio, the area under the curve (AUC) was 0.525 [95% confidence interval (CI): 0.24–0.811] in TN disease and 0.722 [95% CI: 0.449–0.995] in HER2-positive disease. According to radiologic responses and pathological responses, the ADC ratio in rCR plus pCR in TN disease was not changed among other response groups (ADC: 3.68±2.91), whereas it was higher than that in the other response groups in HER2-positive disease (ADC: 5.95±4.07).

Conclusions

A high ADC ratio in DWI plus rCR in DCE-MRI may be promising findings for the successful prediction of response in patients with HER2-positive breast cancer rather than in patients with TN breast cancer treated with NAC.

Clinical trial identification

Legal entity responsible for the study

Yokkaichi Municipal Hospital

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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