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
3082 - Prognostic and predictive role of body mass index (BMI) in metastatic colorectal cancer (mCRC): a pooled analisys of TRIBE and TRIBE-2 studies by GONO
Presenter: Emanuela Dell'Aquila
Session: Poster Display session 2
Resources:
Abstract
3618 - Drug holidays and overall survival in patients treated for metastatic colorectal cancer
Presenter: Silvio Ken Garattini
Session: Poster Display session 2
Resources:
Abstract
6111 - Quality of life during 1st-line FOLFOXIRI+/- panitumumab in RAS wild-type metastatic colorectal cancer: Results from the randomized VOLFI trial (AIO KRK-0109)
Presenter: Michael Geissler
Session: Poster Display session 2
Resources:
Abstract
1042 - A biomarker combination indicating resistance to FOLFOX plus bevacizumab in metastastic colorectal cancer : results of phase I of the PERMAD trial
Presenter: Thomas Seufferlein
Session: Poster Display session 2
Resources:
Abstract
3291 - Microsatellite Instability (MSI) status and prognosis in colorectal cancer: meta-analysis
Presenter: James Toh
Session: Poster Display session 2
Resources:
Abstract
2046 - Choosing the right strategy based on individualized treatment effect predictions: Combination versus sequential chemotherapy in patients with metastatic colorectal cancer.
Presenter: Miriam Koopman
Session: Poster Display session 2
Resources:
Abstract
2589 - Noninferiority on overall survival of every-2-weeks vs weekly schedule of cetuximab for first-line treatment of RAS wild-type metastatic colorectal cancer
Presenter: Stefan Kasper
Session: Poster Display session 2
Resources:
Abstract
4944 - POLAF study: Efficacy and safety of FOLFIRI/aflibercept in a phase II trial in patients with metastatic colorectal cancer: Results of plasmatic prognostic and predictive markers
Presenter: Maria Elena Elez Fernandez
Session: Poster Display session 2
Resources:
Abstract
2042 - The accuracy of the clinical PCI score in patients with peritoneal carcinomatosis of colorectal cancer
Presenter: Nadine De Boer
Session: Poster Display session 2
Resources:
Abstract
2667 - The impact of late-line treatment on overall survival (OS) from the initiation of first-line chemotherapy (CT) for patients (pts) with metastatic colorectal cancer (mCRC).
Presenter: Takeshi Kawakami
Session: Poster Display session 2
Resources:
Abstract