Abstract 3911
Background
A decrease in tumor metabolic activity have been shown to be an early indicator of treatment effectiveness for breast cancer.
Methods
We reviewed the records of patients enrolled to the prospective study of prediction of preoperative chemotherapy response (MILESTONE-BreastPred). In the whole group PET/CT was used as an initial method of staging and as response assessment after 1st cycle of chemotherapy. We analysed data of 425 patients, 19.8% TNBC, 12.2% nonluminal HER2-positive and 68% luminal cancers. 88% of patients were stage II or III. pCR rate was 24.8% (ypT0/is ypN0). 31.1% of patients showed progressive disease during follow-up. The aim of the study was to assess the clinical utility of various cut-offs of SUVmax decrease to predict both pCR and disease relapse.
Results
We analysed SUVmax decrease cut-off of 20%, 30%, 40%, 50 and 60%. For pCR prediction, the sensititivity was above 50% for cut-offs 20%-40%, while specificity exceeded 50% for cut-off values 40-60%. In the whole range of cut-offs, there was highly statistically significant difference in pCR rate between low and high SUVmax decrease (p < 0.001). Cut-off of 40% was chosen, providing optimal trade-off between sensitivity and specificity with positive likelihood ratio 1.89, negative likelihood ratio 0.49, PPV 38.4% and PPV 86.0%. Prediction of disease relapse based on 1st cycle SUVmax decrease was more challenging, with sensitivity above 50% for cut-offs 20-30% and specificity above 50% for cut-offs 40-60%. For cut-off 40% the difference in disease relapse between groups was closest to the limit of statistical significance (p = 0.085) and provided PLR 0.81, NLR 1.17, PPV 26.6% and NPV 65.6%.
Conclusions
Prediction of pCR by 1st cycle SUVmax decrease was feasible, with good balance of specificity and sensitivity for cut-off 40%. This cut-off provides the most prominent, although not significant in this analysis, association with the risk of disease relapse. The study was supported by the Polish National Center of Research and Development MILESTONE project–Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no.STRATEGMED2/267398/4/NCBR/2015.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
The study was supported by the Polish National Center of Research and Development MILESTONE project – Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no. STRATEGMED 2/267398/4/NCBR/2015.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3902 - The efficacy of preoperative breast cancer chemotherapy without anti-HER2-targeted treatment – single center experience in setting of no reimbursement in Poland (2011-2015)
Presenter: Agnieszka Badora-Rybicka
Session: Poster Display session 2
Resources:
Abstract
4733 - A Multicentre, International Neoadjuvant (NA), Randomized, Double-blind Phase III Trial comparing FULVESTRANT to a combination of FULVESTRANT and PALBOCICLIB in patients with operable Luminal Breast Cancer (SAFIA Trial)
Presenter: Jean-Marc Nabholtz
Session: Poster Display session 2
Resources:
Abstract
5227 - Outcome of Non-metastatic Male Breast Cancer: 222 patients
Presenter: Ulku Yalcintas Arslan
Session: Poster Display session 2
Resources:
Abstract
5943 - Effects of delayed initiation of adjuvant trastuzumab for non-metastatic, Her2 positive breast cancer in a limited resources setting: ML25232 study final results
Presenter: Samir Beslija
Session: Poster Display session 2
Resources:
Abstract
1725 - Final results of scalp cooling for hair preservation: A single- institution prospective study.
Presenter: Dario Loparco
Session: Poster Display session 2
Resources:
Abstract
3713 - Adjuvant Systemic Therapy in Women with Early Breast Cancer and Intermediate Prosigna ROR Scores: Is Chemotherapy Use Declining? Evidence From a Large Practice
Presenter: Lowell Hart
Session: Poster Display session 2
Resources:
Abstract
818 - Management of early breast cancer in women over 90: A 10 year experience
Presenter: Emily Coffey
Session: Poster Display session 2
Resources:
Abstract
1141 - Evolution in the risk of adverse events of adjuvant endocrine therapy in postmenopausal women with early- stage breast cancer.
Presenter: Daniel Reinhorn
Session: Poster Display session 2
Resources:
Abstract
2277 - Hepatitis B screening and incidence of flare among non-metastatic breast cancer patients treated with anthracyclines
Presenter: Zewen Zhang
Session: Poster Display session 2
Resources:
Abstract
2781 - Effect of denosumab on low bone mineral density in postmenopausal Japanese early breast cancer patients receiving aromatase nhibitors : 36-month results
Presenter: Koichi Sakaguchi
Session: Poster Display session 2
Resources:
Abstract