[18F]FDG and [18F]FLT PET for the evaluation of response to neo-adjuvant chemotherapy in a model of triple negative breast cancer

Abstract

RationalePathological response to neo-adjuvant chemotherapy (NAC) represents a commonly used predictor of survival in triple negative breast cancer (TNBC) and the need to identify markers that predict response to NAC is constantly increasing. Aim of this study was to evaluate the potential usefulness of PET imaging with [18F]FDG and [18F]FLT for the discrimination of TNBC responders to Paclitaxel (PTX) therapy compared to the response assessed by an adapted Response Evaluation Criteria In Solid Tumors (RECIST) criteria based on tumor volume (Tumor Volume Response).MethodsNu/nu mice bearing TNBC lesions of different size were evaluated with [18F]FDG and [18F]FLT PET before and after PTX treatment. SUVmax, Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) and Proliferation (TLP) were assessed using a graph-based random walk algorithm.ResultsWe found that in our TNBC model the variation of [18F]FDG and [18F]FLT SUVmax similarly defined tumor response to therapy and that SUVmax variation represented the most accurate parameter. Response evaluation using Tumor Volume Response (TVR) showed that the effectiveness of NAC with PTX was completely independent from lesions size at baseline.ConclusionsOur study provided interesting results in terms of sensitivity and specificity of PET in TNBC, revealing the similar performances of [18F]FDG and [18F]FLT in the identification of responders to Paclitaxel.

Down-Regulation of Toll-Like Receptor 5 (TLR5) Increased VEGFR Expression in Triple Negative Breast Cancer (TNBC) Based on Radionuclide Imaging

“…It is undeniable that 18 F-FDG plays an important role in the staging of TNBC and efficacy evaluation of chemotherapy, but the specificity of 18 F-FDG is not high (37). In this study, comparative experiment of 125 I-IgG and 125 I-anti-TLR5 mAb imaging, as well as 125 I-VEGF and 125 I-VEGF blocking imaging, revealed the specificity of 125 I-anti-TLR5 mAb and 125 I-VEGF, and both of 125 I-anti-TLR5 mAb and 125 I-VEGF were much more specific than 18 F-FDG.…”

Machine learning with multiparametric magnetic resonance imaging of the breast for early prediction of response to neoadjuvant chemotherapy

“…Although the assessment of tumor response to NAC may be measured with mammography, breast ultrasound, or molecular imaging [ [6] , [7] , [8] , [9] , [10] , [11] ], magnetic resonance imaging (MRI) is the most sensitive imaging technique for the assessment and prediction of response [ [12] , [13] , [14] , [15] , [16] ]. In studies to date, tumor burden/tumor response has been assessed typically with multiparametric MRI prior to NAC, after NAC, and sometimes during NAC as well.…”

Preclinical Molecular Imaging for Precision Medicine in Breast Cancer Mouse Models

“…Implementing the use of PET in preliminary breast cancer studies may support clinical decision-making through monitoring receptor expression during treatment, aiming at developing personalized treatment strategies and/or predicting prognosis [104]. Interesting results, for example, were collected on sensitivity and specificity of PET in identifying NAC responders in TNBC mouse models [105]. The translation of novel radiotracers for precision imaging would improve the clinical management and outcome of patients affected, in particular TNBC patients, who rely upon a limited number of therapeutic opportunities with poor prognosis [105].…”

“…Interesting results, for example, were collected on sensitivity and specificity of PET in identifying NAC responders in TNBC mouse models [105]. The translation of novel radiotracers for precision imaging would improve the clinical management and outcome of patients affected, in particular TNBC patients, who rely upon a limited number of therapeutic opportunities with poor prognosis [105]. Furthermore, CEUS using targeted VEGFR2 MBs has been evaluated in clinical settings, and is considered as an additional screening modality, other than mammography and conventional ultrasonography, to improve diagnostic accuracy for early detection of breast cancer or even for its precursor lesions.…”