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BMC Cancer

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Open Access 01-12-2021 | Breast Cancer | Research

Prospective comparison of early interim ¹⁸F-FDG-PET with ¹⁸F-FLT-PET for predicting treatment response and survival in metastatic breast cancer

Authors: Tzu-Pei Su, Jen-Seng Huang, Pei-Hung Chang, Kar-Wai Lui, Jason Chia-Hsun Hsieh, Shu-Hang Ng, Sheng-Chieh Chan

Published in: BMC Cancer | Issue 1/2021

Abstract

Background

To compare the value of interim ¹⁸F-FLT-PET and ¹⁸F-FDG-PET for predicting treatment outcomes in patients with metastatic breast cancer after salvage therapy.

Methods

Patients with metastatic breast cancer received PET/CT using ¹⁸F-FLT and ¹⁸F-FDG at baseline, after the 1st and 2nd cycle of systemic chemotherapy. The clinical response was classified according to Response Evaluation Criteria in Solid Tumors 1.1 based on contrast-enhanced CT after 3 months of systemic chemotherapy. The metabolic response on PET was assessed according to European Organization for Research and Treatment of Cancer criteria or PET Response Criteria in Solid Tumors (PERCIST) and was correlated to the clinical response, overall survival (OS), and progression-free survival (PFS).

Results

Twenty-five patients entered final analysis. On ¹⁸F-FDG-PET, clinical responders after 2 chemotherapy cycles (post-2c) had a significantly greater reduction of maximal standardized uptake value (SUV) and the peak SUV corrected for lean body mass (SULpeak) of the tumor than non-responders (P = 0.030 and 0.003). Metabolic response determined by PERCIST on post-2c ¹⁸F-FDG-PET showed a high area under the receiver operating characteristics curve of 0.801 in predicting clinical response (P = 0.011). Patients who were metabolic responders by PERCIST on post-2c ¹⁸F-FDG-PET had a significantly longer PFS (53.8% vs. 16.7%, P = 0.014) and OS (100% vs. 47.6%, P = 0.046) than non-responders. Survival differences between responders and non-responders in the interim ¹⁸F-FLT-PET were not significant.

Conclusions

¹⁸F-FLT-PET failed to show an advantage over ¹⁸F-FDG-PET in predicting the treatment response and survival in patients with metastatic breast cancer. Assessment of treatment outcome by interim ¹⁸F-FDG-PET may aid treatment.

Trial registration

The study was retrospectively registered on 02/06/2020 on Clinicaltrials.gov (identifier NCT04411966).

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Title: Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer
Authors: Tzu-Pei Su
Jen-Seng Huang
Pei-Hung Chang
Kar-Wai Lui
Jason Chia-Hsun Hsieh
Shu-Hang Ng
Sheng-Chieh Chan
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Breast Cancer
Breast Cancer
Positron Emission Tomography
Cytostatic Therapy
Published in: BMC Cancer / Issue 1/2021
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-021-08649-z

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Abstract

Background

Methods

Results

Conclusions

Trial registration

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