par Mileva, Magdalena 
;de Vries, Elisabeth E.G.E.;Guiot, Thomas ;Wimana, Zéna;Deleu, Anne-Leen ;Schröder, Carolien P;Lefebvre, Y.;Paesmans, Marianne ;Stroobants, Sigrid;Huizing, Manon T;Aftimos, Philippe ;Tol, Jolien;Van Der Graaf, Winette Ta A;Oyen, Wim Jg G;Vugts, Danielle;Menke-van der Houven van Oordt, Willemien C.W.;Brouwers, Adrienne A.H.;Piccart-Gebhart, Martine ;Flamen, Patrick ;Gebhart, Géraldine
Référence NPJ breast cancer, 10, 1, 4
Publication Publié, 2024-12
;de Vries, Elisabeth E.G.E.;Guiot, Thomas ;Wimana, Zéna;Deleu, Anne-Leen ;Schröder, Carolien P;Lefebvre, Y.;Paesmans, Marianne ;Stroobants, Sigrid;Huizing, Manon T;Aftimos, Philippe ;Tol, Jolien;Van Der Graaf, Winette Ta A;Oyen, Wim Jg G;Vugts, Danielle;Menke-van der Houven van Oordt, Willemien C.W.;Brouwers, Adrienne A.H.;Piccart-Gebhart, Martine ;Flamen, Patrick ;Gebhart, Géraldine Référence NPJ breast cancer, 10, 1, 4
Publication Publié, 2024-12
Article révisé par les pairs
| Résumé : | Efficacy of the human epidermal growth factor receptor (HER)2-targeting trastuzumab emtansine (T-DM1) in breast cancer (BC) relies on HER2 status determined by immunohistochemistry or fluorescence in-situ hybridization. Heterogeneity in HER2 expression, however, generates interest in “whole-body” assessment of HER2 status using molecular imaging. We evaluated the role of HER2-targeted molecular imaging in detecting HER2-positive BC lesions and patients unlikely to respond to T-DM1. Patients underwent zirconium-89 (89Zr) trastuzumab (HER2) PET/CT and [18F]-2-fluoro-2-deoxy-D-glucose (FDG) PET/CT before T-DM1 initiation. Based on 89Zr-trastuzumab uptake, lesions were visually classified as HER2-positive (visible/high uptake) or HER2-negative (background/close to background activity). According to proportion of FDG-avid tumor load showing 89Zr-trastuzumab uptake (entire/dominant part or minor/no part), patients were classified as HER2-positive and HER2-negative, respectively. Out of 265 measurable lesions, 93 (35%) were HER2-negative, distributed among 42 of the 90 included patients. Of these, 18 (19%) lesions belonging to 11 patients responded anatomically (>30% decrease in axial diameter from baseline) after three T-DM1 cycles, resulting in an 81% negative predictive value (NPV) of the HER2 PET/CT. In combination with early metabolic response assessment on FDG PET/CT performed before the second T-DM1 cycle, NPVs of 91% and 100% were reached in predicting lesion-based and patient-based (RECIST1.1) response, respectively. Therefore, HER2 PET/CT, alone or in combination with early FDG PET/CT, can successfully identify BC lesions and patients with a low probability of clinical benefit from T-DM1. |
