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

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

doi:10.1186/s12885-021-08649-z

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

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

^*Corresponding author for this work

School of Traditional Chinese Medicine

Research output: Contribution to journal › Journal Article › peer-review

6 Scopus citations

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).

Original language	English
Article number	908
Journal	BMC Cancer
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12885-021-08649-z
State	Published - 12 2021

Bibliographical note

Publisher Copyright:
© 2021, The Author(s).

Keywords

Breast cancer
F-FDG
F-FLT
Positron-emission tomography
Prognosis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12885-021-08649-z

Cite this

@article{cf1eaa4fab3643009cb361fcdc0d88c4,

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

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).",

keywords = "Breast cancer, F-FDG, F-FLT, Positron-emission tomography, Prognosis",

author = "Su, {Tzu Pei} and Huang, {Jen Seng} and Chang, {Pei Hung} and Lui, {Kar Wai} and Hsieh, {Jason Chia Hsun} and Ng, {Shu Hang} and Chan, {Sheng Chieh}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s12885-021-08649-z",

language = "英语",

volume = "21",

journal = "BMC Cancer",

issn = "1471-2407",

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number = "1",

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TY - JOUR

T1 - Prospective comparison of early interim 18F-FDG-PET with 18F-FLT-PET for predicting treatment response and survival in metastatic breast cancer

AU - Su, Tzu Pei

AU - Huang, Jen Seng

AU - Chang, Pei Hung

AU - Lui, Kar Wai

AU - Hsieh, Jason Chia Hsun

AU - Ng, Shu Hang

AU - Chan, Sheng Chieh

PY - 2021/12

Y1 - 2021/12

N2 - 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).

AB - 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).

KW - Breast cancer

KW - F-FDG

KW - F-FLT

KW - Positron-emission tomography

KW - Prognosis

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U2 - 10.1186/s12885-021-08649-z

DO - 10.1186/s12885-021-08649-z

M3 - 文章

C2 - 34376155

AN - SCOPUS:85112338914

SN - 1471-2407

VL - 21

JO - BMC Cancer

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M1 - 908

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