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Evaluation of [ 89 Zr]trastuzumab-PET/CT in differentiating HER2-positive from HER2-negative breast cancer.
- Source :
-
Breast cancer research and treatment [Breast Cancer Res Treat] 2018 Jun; Vol. 169 (3), pp. 523-530. Date of Electronic Publication: 2018 Feb 13. - Publication Year :
- 2018
-
Abstract
- Purpose: To evaluate whether tumor uptake of [ <superscript>89</superscript> Zr]trastuzumab can distinguish HER2-positive from HER2-negative breast cancer.<br />Methods: Women with HER2-positive (n = 34) and HER2-negative (n = 16) breast cancer underwent PET/CT 5 ± 2 days following [ <superscript>89</superscript> Zr]trastuzumab administration. HER2 status was determined based on immunohistochemistry and/or fluorescence in situ hybridization of primary or metastatic/recurrent tumor. Tumor [ <superscript>89</superscript> Zr]trastuzumab uptake was assessed qualitatively and semiquantitatively as maximum standardized uptake value (SUV <subscript>max</subscript> ), and correlated with HER2 status. Additionally, intrapatient heterogeneity of [ <superscript>89</superscript> Zr]trastuzumab uptake was evaluated.<br />Results: On a per-patient basis, [ <superscript>89</superscript> Zr]trastuzumab-PET/CT was positive in 30/34 (88.2%) HER2-positive and negative in 15/16 (93.7%) HER2-negative patients. Considering all lesions, the SUV <subscript>max</subscript> was not significantly different in patients with HER2-positive versus HER2-negative disease (p = 0.06). The same was true of when only hepatic lesions were evaluated (p = 0.42). However, after excluding hepatic lesions, tumor SUV <subscript>max</subscript> was significantly higher in HER2-positive compared to HER2-negative patients (p = 0.003). A cutoff SUV <subscript>max</subscript> of 3.2, determined by ROC analysis, demonstrated positive-predictive value of 83.3% (95% CI 65.3%, 94.4%), sensitivity of 75.8% (57.7%, 88.9%), negative-predictive value of 50% (24.7%, 75.3%), and specificity of 61.5% (95% 31.6%, 86.1%) for differentiating HER2-positive from HER2-negative lesions. There was intrapatient heterogeneity of [ <superscript>89</superscript> Zr]trastuzumab uptake in 20% of patients with multiple lesions.<br />Conclusions: [ <superscript>89</superscript> Zr]trastuzumab has the potential to characterize the HER2 status of the complete tumor burden in patients with breast cancer, thus obviating repeat or multiple tissue sampling to assess intrapatient heterogeneity of HER2 status.
- Subjects :
- Adult
Aged
Biomarkers, Tumor
Biopsy
Female
Humans
Image Processing, Computer-Assisted
Middle Aged
Multimodal Imaging methods
Neoplasm Grading
Neoplasm Staging
ROC Curve
Sensitivity and Specificity
Breast Neoplasms diagnosis
Breast Neoplasms metabolism
Positron Emission Tomography Computed Tomography methods
Radioisotopes administration & dosage
Radiopharmaceuticals administration & dosage
Receptor, ErbB-2 metabolism
Trastuzumab administration & dosage
Zirconium administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7217
- Volume :
- 169
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Breast cancer research and treatment
- Publication Type :
- Academic Journal
- Accession number :
- 29442264
- Full Text :
- https://doi.org/10.1007/s10549-018-4696-z