Heterogeneity of Metabolic Response to Systemic Therapy in Metastatic Breast Cancer Patients

Huyge, Valérie; Garcia, Camilo; Alexiou, J.; Ameye, Lieveke; Vanderlinden, Bruno; Lemort, Marc; Bergmann, Pierre; Awada, Ahmad; Body, Jean‐Jacques; Flamen, Patrick

doi:10.1016/j.clon.2010.05.021

Cited by 55 publications

(30 citation statements)

References 21 publications

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“…Several clinical observations of different tumor types have shown variability in response to therapy that can occur between metastases or within a single-tumor mass. [15][16][17][18] This variability may be explained by the emergence of genomically distinct clones of malignant cells.…”

Section: Discussionmentioning

confidence: 99%

Identification of immunotherapeutic targets by genomic profiling of rectal NET metastases

et al. 2016

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Neuroendocrine tumors (NETs) of the gastrointestinal tract are a rare and heterogeneous group of neoplasms with unique tumor biology and clinical management issues. While surgery is the only curative treatment option in patients with early stage NETs, the optimal management strategy for patients with advanced metastatic NETs is unknown. Based on the tremendous success of immunotherapeutic approaches, we sought to investigate such approaches in a case of metastatic rectal NET. Here, we apply an integrative approach using various computational and experimental methods to explore several aspects of the tumor-host immune interactions for immunotherapeutic options. Sequencing of six different liver metastases revealed a quite homogenous set of mutations, and further analysis of these mutations for immunogenicity revealed few neo-epitopes with pre-existing T cell reactivity, which can be used in therapeutic vaccines. Staining for immunomodulatory proteins and cytokine profiling showed that the immune setting is surprisingly different, when compared to liver metastases of colorectal cancer for instance. Taken together, our results highlight the broad range and complexity of tumor-host immune interaction and underline the value of an integrative approach.

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Section: Discussionmentioning

confidence: 99%

Identification of immunotherapeutic targets by genomic profiling of rectal NET metastases

et al. 2016

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“…A retrospective study using 18 F-FDG-PET/CT to monitor response among lesions in patients with bone-dominant metastatic breast cancer treated with systemic therapies reported that lesions showed heterogeneous metabolic response amongst responding and nonresponding bony and non-bony lesions. 13 Novel utilization of 18 F-FDG-PET/CT in recent years, such as texture analysis on CT imaging, has been shown to reflect tumour heterogeneity and associated prognosis. This has been examined in multiple tumour types, including lung, [14][15][16] colorectal [17][18][19] and oesophageal 20 cancers.…”

Section: Various Imaging Modalities and Methods That Can Help To Map mentioning

confidence: 99%

The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis

Chowdhury¹,

Ganeshan²,

Irshad³

et al. 2014

BJR|case reports

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“…Another important finding is that PET/CT allows evaluation of response in many different metastases. Huyge et al [94] have demonstrated that PET/CT is helpful for indicating a heterogeneous response (coexistence of responding and non-responding lesions within the same patient). In the future, it will be necessary to evaluate the association between treatment response and patient survival outcome.…”

Section: Evaluation Of the Response Of Metastatic Diseasementioning

confidence: 99%

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Kitajima

Miyoshi

2016

Jpn J Radiol

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by malignant cells, opened a new field in clinical oncologic imaging. Recently, integrated positron emission tomography/computed tomography (PET/CT), in which a full-ringdetector clinical PET scanner and multidetector-row helical CT scanner are combined, has made it possible to acquire both metabolic and anatomic imaging data using a single device in a single diagnostic session, and provides precise anatomic localization of suspicious areas of increased FDG uptake. When used in a clinical setting, FDG-PET/CT leads to a significant improvement in diagnostic accuracy and has had a considerable impact on patient management, including diagnosis, initial staging, optimization of treatment, restaging, monitoring of the response to therapy, and prognostication of various malignant tumors. We herein review the current and future roles of FDG-PET/CT in the management of breast cancer, discussing its usefulness and limitations for imaging in these patients. DiagnosisFDG-PET imaging has poor sensitivity (<50 %) for subcentimeter breast cancers [9,10]. This is due to the limited spatial resolution of PET and, in some cases, by tumor characteristics (e.g., low FDG avidity in grade 1 cancer, ductal carcinoma in situ, or lobular carcinoma) [1,2]. Specificity can also be altered by variations of FDG uptake in certain benign conditions, such as infection, fibroadenoma, ductal adenoma, inflammatory granulomatous mastitis, and fibrocystic changes [3].In order to improve specificity, some authors would obtain a second series of PET images centered on the breast approximately 2 h after FDG injection (dual-time imaging) [4]. Indeed, FDG uptake seems to increase with time in the case of malignancy, while some inflammatory lesions show stable or decreasing uptake [4]. However, dual-time Abstract Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxyd-glucose (FDG) is a useful tool for acquisition of both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the diagnosis, initial staging, restaging, early treatment response assessment, evaluation of metastatic disease response, and prognostication of breast cancer as well as various malignant tumors. We herein review the current place and role of FDG-PET/CT in the management of breast cancer, focusing on its usefulness and limitations in the imaging of these patients.

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Heterogeneity of Metabolic Response to Systemic Therapy in Metastatic Breast Cancer Patients

Cited by 55 publications

References 21 publications

Identification of immunotherapeutic targets by genomic profiling of rectal NET metastases

Identification of immunotherapeutic targets by genomic profiling of rectal NET metastases

The use of molecular imaging combined with genomic techniques to understand the heterogeneity in cancer metastasis

Present and future role of FDG-PET/CT imaging in the management of breast cancer

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