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
4546 - Efficacy and toxicity of weekly carboplatin and paclitaxel as induction or palliative treatment in advanced esophageal cancer patients
Presenter: Femke de Man
Session: Poster Display session 2
Resources:
Abstract
5908 - Perioperative chemotherapy with Docetaxel, Oxaliplatin, Fluorouracil and Leucovorin (FLOT) versus Epirubicin, Platinum and Capecitabine or Flourouracil (EOX/ECF) in Resectable Gastric or Gastroesophageal Junction Adenocarcinoma- Safety and response data from India.
Presenter: Tanuj Chawla
Session: Poster Display session 2
Resources:
Abstract
937 - Phase II Study of Preoperative Radiotherapy Combined with S-1 plus Cisplatin in Clinically Resectable Type 4 or Large Type 3 Gastric Cancer: OGSG1205
Presenter: Shunji Endo
Session: Poster Display session 2
Resources:
Abstract
1119 - Observational Study of the Peritoneal Washing Cytology Positive Gastric Cancer without Gross Peritoneal Metastasis Underwent Radical D2 Gastrectomy.
Presenter: Jun Eul Hwang
Session: Poster Display session 2
Resources:
Abstract
3744 - Primary results of multicenter phase II study of neoadjuvant chemotherapy with S-1 and oxaliplatin for locally advanced gastric cancer (Neo G-SOX PII)
Presenter: Akira Miki
Session: Poster Display session 2
Resources:
Abstract
5091 - Multicenter Phase I/II Feasibility Study of Adjuvant Treatment with S-1 in Patients after R0-Resection of Adenocarcinoma of the Stomach and Esophagogastric Junction (GMBH-STO-0114)
Presenter: Kathrin Heinrich
Session: Poster Display session 2
Resources:
Abstract
2891 - A phase I study of Docetaxel/Oxaliplatin/S-1 (DOS) combination neoadjuvant chemotherapy for patients with locally advanced adenocarcinoma of the esophagogastric junction
Presenter: Kei Hosoda
Session: Poster Display session 2
Resources:
Abstract
2994 - Apatinib combined with docetaxel in second-line treatment of advanced gastric cancer: a prospective clinical study (Data updated)
Presenter: Mudan Yang
Session: Poster Display session 2
Resources:
Abstract
3000 - A multicenter phase II study of TAS-114 in combination with S-1 in patients with pre-treated advanced gastric cancer (EPOC1604)
Presenter: Daisuke Takahari
Session: Poster Display session 2
Resources:
Abstract
4653 - Impact of Pembrolizumab (pembro) Versus Paclitaxel on Health-Related Quality of Life (HRQoL) in Patients With Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer That Has Progressed After First-Line Chemotherapy (KEYNOTE-061)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract