Abstract 2632
Background
Dedicated breast positron emission tomography (DbPET) with 18F-fluorodeoxyglucose (FDG) can detect intratumoral heterogeneity. In a previous study, we proved that intratumoral heterogeneous distribution of FDG on DbPET is significantly related to a high nuclear grade and high Ki-67 proliferation index; we also proved that DbPET is useful for predicting residual breast tumors after neoadjuvant chemotherapy (NAC). This study included patients with breast cancer who exhibited a ring-like uptake without central FDG accumulation on DbPET and aimed to evaluate whether the uptake can predict the effects of NAC in patients with breast cancer.
Methods
The study included 83 consecutive patients with breast cancer who subsequently underwent DbPET and NAC between August 2016 and March 2019 and evaluated the relationship between pathological response to NAC and clinicopathologic factors (clinical T1: n = 14; clinical N0: n = 33; nuclear grade 1 or 2: n = 22; Ki67 ≥ 20: n = 78; ER positive: n = 52; and HER-2 positive: n = 32), such as intratumoral heterogeneous distribution of FDG (positive: n = 54) and ring-like uptake without central FDG accumulation (positive: n = 11) on DbPET images.
Results
Surgical pathological findings obtained after the NAC indicated pathological complete response (pCR) and non-pCR in 32 (38.6%) and 51 (61.4%) patients, respectively. For all the patients, significant predictors for pCR were identified in univariate analyses (clinical T: odds ratio = 3.60, p = 0.03; clinical N: odds ratio = 2.48, p = 0.049; HER-2 overexpression: odds ratio = 2.72, p = 0.03; and ring-like uptake: odds ratio = 5.33, p = 0.01) and multivariate analyses (HER-2 overexpression: odds ratio = 3.29, p = 0.03; ring-like uptake: odds ratio = 17.6, p = 0.0006) (Table).Table:
279P Univariate and multivariate logistic analysis of significant predictive clinicopathological factors for pCR
Characteristic | Univariate logistic analysis | Multivariate logistic analysis | ||||
---|---|---|---|---|---|---|
OR | 95%CI | p | OR | 95%CI | p | |
Age, <50 v ≥ 50 | 1.38 | 0.57-3.38 | 0.48 | 1.97 | 0.65-5.98 | 0.23 |
Clinical T, T1 v T2- T4 | 3.60 | 1.11-12.9 | 0.03 | 3.86 | 0.97-15.4 | 0.06 |
Clinical N, Negative v Positive | 2.48 | 1.00-6.28 | 0.049 | 2.86 | 0.97-8.42 | 0.06 |
Nuclear Grade, 3 v 1-2 | 1.49 | 0.54-4.38 | 0.45 | 1.65 | 0.41-6.70 | 0.48 |
Ki67, ≥20 v < 20 | 2.64 | 0.37-52.8 | 0.36 | 1.34 | 0.11-16.5 | 0.82 |
ER, Negative v Positive | 1.25 | 0.50-3.12 | 0.63 | 1.05 | 0.33-3.34 | 0.93 |
HER-2, Positive v Negative | 2.72 | 1.09-6.94 | 0.03 | 3.29 | 1.11-9.73 | 0.03 |
Intratumoral heterogenity, Positive v Negative | 1.50 | 0.59-3.78 | 0.39 | 1.69 | 0.43-6.57 | 0.45 |
Ring-like uptake, Positive v Negative | 5.33 | 1.40-26.1 | 0.01 | 17.6 | 2.27-136.2 | 0.006 |
Conclusions
Ring-like uptake on DbPET provides predictive value for evaluating pCR to NAC in patients with breast cancer and might inform therapeutic decisions.
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
4401 - Real-world effectiveness of first-line palbociclib + letrozole for metastatic breast cancer 4 years post approval in the US
Presenter: Jonathan Kish
Session: Poster Display session 2
Resources:
Abstract
5876 - Palbociclib-Fulvestrant (PALBO-FUL) and Everolimus -Exemestane (EVE-EXE) for Second line Hormonal Treatment (HT) of Metastatic Breast Cancer (MBC) with Lobular Histology: a Propensity Score Matched Analysis of a Multicenter ‘Real-World’ Patients (pts) Series.
Presenter: Armando Orlandi
Session: Poster Display session 2
Resources:
Abstract
3587 - Dose-escalation study of G1T48, an oral selective estrogen receptor degrader (SERD), in postmenopausal women with ER+/HER2- locally advanced or metastatic breast cancer (ABC)
Presenter: E Dees
Session: Poster Display session 2
Resources:
Abstract
5696 - Final results of the STEM trial: SFX-01 in the Treatment and Evaluation of ER+ Her2- Metastatic breast cancer (mBC)
Presenter: Sacha Howell
Session: Poster Display session 2
Resources:
Abstract
1475 - Alpelisib (ALP) + Fulvestrant (FUL) in Hormone-Receptor Positive (HR+), Human Epidermal Growth Factor Receptor-2–Negative (HER2–) Advanced Breast Cancer (ABC): Subgroup Analysis by Presence of Visceral Metastasis (VM) in the SOLAR-1 Trial
Presenter: Mario Campone
Session: Poster Display session 2
Resources:
Abstract
2549 - Phase 1 Dose Escalation Study of a Selective Androgen Receptor Modulator RAD140 in Estrogen Receptor Positive (ER+), HER2 Negative (HER2-) Breast Cancer (BC)
Presenter: Erika Hamilton
Session: Poster Display session 2
Resources:
Abstract
3787 - A Phase I study of XZP-3287, a novel oral CDK4/6 Inhibitor, administered on a continuous dosing schedule, in patients with advanced solid tumours
Presenter: Binghe Xu
Session: Poster Display session 2
Resources:
Abstract
4835 - Phase-I dose-escalation and expansion study of the PARP inhibitor, fluzoparib (SHR3162), in patients with advanced solid tumors
Presenter: Huiping Li
Session: Poster Display session 2
Resources:
Abstract
5083 - Phase 2 study of DHP107 (Liporaxel®, oral paclitaxel) in first-line, HER2 negative recurrent/metastatic breast cancer (OPTIMAL study, NCT03315364)
Presenter: Jin-Hee Ahn
Session: Poster Display session 2
Resources:
Abstract
2674 - Multicenter Phase I Trial of Trastuzumab Emtansine (T-DM1) in Combination with Non-Pegylated Liposomal Doxorubicin (NPLD) in HER2[+] Metastatic Breast Cancer (MBC). THELMA Study
Presenter: Elena López-Miranda
Session: Poster Display session 2
Resources:
Abstract