Abstract 5792
Background
Early predicting the pathologic complete response (pCR) after neoadjuvant chemotherapy in patients with locally advanced breast cancer (LABC) is closely associated with clinical outcomes. However, conventional metabolic parameters using baseline 18F-FDG PET/CT have failed to accurately predict the pCR. Breast cancer stem cells (CSCs) are known for their established role in chemoresistance. We designed a new PET parameter for CSC metabolism (MTVcsc) from pretreatment 18F-FDG PET/CT by using distinctive glucose metabolism between CSCs and differentiated cancer cells, and aimed to evaluate the prognostic value of the MTVcsc.
Methods
A total of 71 patients with LABC who underwent initial 18F-FDG PET/CT before NAC were included in this study. The SUV values of single voxels within the primary tumor were clustered by performing k-means clustering using R version 3.5.3 and MTVcsc was derived by calculating the volume of the most glycolytic cluster. The predictive values of the MTVcsc, as well as clinicopathologic and conventional metabolic parameters (SUVmax, MTV, TLG) for pCR, were analyzed by multivariable logistic regression.
Results
Seventeen patients were excluded from the final analysis due to small tumor size (< 64 voxels). The lower MTVcsc and non-luminal subtypes were significantly associated with achieving pCR following NAC (Table). The MTVcsc outperformed the conventional PET parameters in predicting pCR. Table Univariable and multivariable logistic regression model of clinicopathologic and metabolic parameters for predicting pathologic complete response.Table: 301P
Parameters | Univariable analysis | Multivariable analysis | ||||
---|---|---|---|---|---|---|
OR | 95% CI | P value | OR | 95% CI | P value | |
Ki-67 | ||||||
Low, < 20% High, ≥ 20% | 1.00 | |||||
5.57 | 1.06-29.27 | 0.043 | ||||
Molecular subtype | ||||||
Luminal A and B HER2 positive Triple negative | 1.00 | 1.00 | ||||
11.46 | 2.07-63.36 | 0.005 | 13.7 | 1.75-107.36 | 0.013 | |
6.55 | 1.05-40.67 | 0.044 | 17.42 | 1.41-215.04 | 0.026 | |
Metabolic parameters | ||||||
SUVmax Metabolic tumor volume (MTV) Total lesion glycolysis (TLG) MTVcsc | 0.98 | 0.83-1.16 | 0.814 | |||
0.98 | 0.94-1.02 | 0.281 | ||||
0.99 | 0.98-1.00 | 0.231 | ||||
0.29 | 0.10-0.89 | 0.031 | 0.21 | 0.05-0.82 | 0.025 |
Conclusions
MTVcsc, a novel PET parameter for CSC metabolism, provides predictive value for pCR. By further stratifying LABC patients with a combination of MTVcsc and molecular subtype at initial staging workup, achieving pCR after NAC can be early predicted more accurately.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3716 - Prognostic factors for predicting early recurrence within the first year of surgery in pancreatic ductal adenocarcinoma
Presenter: Naru Kim
Session: Poster Display session 2
Resources:
Abstract
3947 - Integrated population pharmacokinetic modelling of liposomal irinotecan in patients with various tumour types, including untreated metastatic pancreatic cancer (mPC)
Presenter: Teresa Macarulla
Session: Poster Display session 2
Resources:
Abstract
2880 - Expression of long noncoding RNA and clinical outcomes of pancreatic cancer patients who received adjuvant chemotherapy by S-1 or GEM after curative resection.
Presenter: Mariko Kamiya
Session: Poster Display session 2
Resources:
Abstract
5029 - POLO: Time to treatment discontinuation and subsequent therapies following maintenance olaparib for patients (pts) with a germline BRCA mutation and metastatic pancreatic cancer (mPC)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract
4730 - Diagnostic Value of Digital Multiplexed Detection of Single Nucleotide Variants in Pancreatic Cancer Specimens Collected by Endoscopic Ultrasound Fine-Needle Aspiration
Presenter: Irina Cazacu
Session: Poster Display session 2
Resources:
Abstract
3303 - Phase I/II study of LDE225 in combination with gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer
Presenter: Esther Pijnappel
Session: Poster Display session 2
Resources:
Abstract
2009 - Efficacy of platinum-containing chemotherapy and prognosis of pancreatic cancer patients with homologous recombination deficiency: meta-analysis of published clinical studies
Presenter: Elizeveta Polyanskaya
Session: Poster Display session 2
Resources:
Abstract
2164 - Plasmatic CXCL8 is a marker for TGFß-activated kinase 1 (TAK1) activation which may predict resistance to nanoliposomal irinotecan (nal-IRI) in gemcitabine-refractory pancreatic cancer (PC) patients
Presenter: Valeria Merz
Session: Poster Display session 2
Resources:
Abstract
2529 - A protein level signature of four selected genes associated with survival outcomes of patients with pancreatic ductal adenocarcinoma
Presenter: Jie Hua
Session: Poster Display session 2
Resources:
Abstract
4947 - Pre-treatment serum 25-hydroxyvitamin D levels and survival in a Danish cohort of patients with pancreatic cancer
Presenter: Louise Rasmussen
Session: Poster Display session 2
Resources:
Abstract