Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation?

Jansson, Tomas; Westlin, Jan‐Erik; Åhlström, Håkan; Lilja, Anders; Långström, Bengt; Bergh, Jonas

doi:10.1200/jco.1995.13.6.1470

Cited by 226 publications

(94 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A decrease in tumor 18 F-FDG uptake was observed in 8 of 12 patients who had metastatic disease and who responded after the first cycle of chemotherapy (47). In another study, a rapid decrease in tumor glucose metabolism was observed after the first cycle of therapy in 6 of 9 responding patients, but there was no substantial decrease in nonresponding patients (48).…”

Section: Metabolic Response To Therapy Of Metastatic Breast Cancermentioning

confidence: 92%

Response to Therapy in Breast Cancer

2009

View full text Add to dashboard Cite

Increasing numbers of patients with newly diagnosed breast cancer receive primary systemic therapy followed by surgery. Histopathology provides an accurate assessment of treatment efficacy on the basis of the extent of residual tumor and regressive changes within tumor tissue. However, only approximately 20% of breast cancer patients achieve a pathologic complete response, a fact that necessitates methods for monitoring therapeutic effectiveness early during therapy. 18 F-FDG PET and 18 F-FDG PET/CT provide essential information regarding a response to primary chemotherapy. Patients with low tumor metabolic activity on pretreatment 18 F-FDG PET are not likely to achieve a histopathologic response. The degree of changes in 18 F-FDG uptake after the initiation of therapy is correlated with the histopathologic response after the completion of therapy. Thus, tumor metabolic changes assessed early during therapy predict therapeutic effectiveness in individual patients. Early identification of ineffective therapy also might be helpful in patients with metastatic breast cancer because many palliative treatment options are available. Changes in metabolic activity generally occur earlier than changes in tumor size, which is the current standard for the assessment of a response. Although treatment stratification based on a metabolic response is an exciting potential application of PET, specific PET response assessment criteria still need to be developed and validated on the basis of patient outcomes before changes in treatment regimens can be implemented. There is increasing clinical evidence for metastatic breast cancer and other tumors that 18 F-FDG PET/ CT is the most accurate imaging procedure for assessment of the response at the end of treatment when both CT information and tumor metabolic activity are considered. Importantly, in the setting of primary chemotherapy, neither PET/CT nor conventional imaging procedures can assess the extent of residual breast cancer as accurately as histopathology. Observation of changes in tumor blood flow or tumor cell proliferation is an additional encouraging approach for predicting a response. Ultimately, the prediction of therapeutic effectiveness by PET and PET/CT could help to individualize treatment and to avoid ineffective chemotherapies, with their associated toxicities.

show abstract

Section: Metabolic Response To Therapy Of Metastatic Breast Cancermentioning

confidence: 92%

Response to Therapy in Breast Cancer

2009

View full text Add to dashboard Cite

show abstract

“…18 F-FDG PET, however, is a functional measure of tumor metabolic activity, which is potentially more sensitive in detecting change to therapy than anatomic measurements. 18 F-FDG PET has been demonstrated to be useful in the prediction of response to chemotherapy in several solid tumors, with the reduction in 18 F-FDG uptake often preceding radiological changes (4)(5)(6)(20)(21)(22). There are also emerging survival data with metabolic responses associated with a survival advantage in lung, breast, esophageal, and pancreatic cancer (5)(6)(7)21,23).…”

Section: Discussionmentioning

confidence: 99%

Early Prediction of Response to Chemotherapy and Survival in Malignant Pleural Mesothelioma Using a Novel Semiautomated 3-Dimensional Volume-Based Analysis of Serial 18F-FDG PET Scans

Francis¹,

Byrne²,

Schaaf³

et al. 2007

Journal of Nuclear Medicine

175

127

View full text Add to dashboard Cite

The aim of chemotherapy for mesothelioma is to palliate symptoms and improve survival. Measuring response using CT is challenging because of the circumferential tumor growth pattern. This study aims to evaluate the role of serial 18 F-FDG PET in the assessment of response to chemotherapy in patients with mesothelioma. Methods: Patients were prospectively recruited and underwent both 18 F-FDG PET and conventional radiological response assessment before and after 1 cycle of chemotherapy. Quantitative volume-based 18 F-FDG PET analysis was performed to obtain the total glycolytic volume (TGV) of the tumor. Survival outcomes were measured. Results: Twenty-three patients were suitable for both radiological and 18 F-FDG PET analysis, of whom 20 had CT measurable disease. After 1 cycle of chemotherapy, 7 patients attained a partial response and 13 had stable disease on CT assessment by modified RECIST (Response Evaluation Criteria in Solid Tumors) criteria. In the 7 patients with radiological partial response, the median TGV on quantitative PET analysis fell to 30% of baseline (range, 11%-71%). After 1 cycle of chemotherapy, Cox regression analysis demonstrated a statistically significant relationship between a fall in TGV and improved patient survival (P 5 0.015). Neither a reduction in the maximum standardized uptake value (P 5 0.097) nor CT (P 5 0.131) demonstrated a statistically significant association with patient survival. Conclusion: Semiquantitative 18 F-FDG PET using the volume-based parameter of TGV is feasible in mesothelioma and may predict response to chemotherapy and patient survival after 1 cycle of treatment. Therefore, metabolic imaging has the potential to improve the care of patients receiving chemotherapy for mesothelioma by the early identification of responding patients. This technology may also be useful in the assessment of new systemic treatments for mesothelioma.

show abstract

“…Furthermore, effective chemotherapy, when repeated, leads to diminution of glucose uptake levels to basal values while FDG uptake increases in patients receiving inefficient therapy. Reports from Nieweg et al [250], Chaiken et al [225] and Jansson et al [260] also suggest a role for PET in the follow-up of therapy.…”

Section: Breast Cancermentioning

confidence: 99%

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

Rigo¹,

Paulus²,

et al. 1996

View full text Add to dashboard Cite

Abstract. Positron emission tomography (PET) is now primarily used in oncological indication owing to the successful application of fluorine-18 fluorodeoxyglucose (FDG) in an increasing number of clinical indications at different stages of diagnosis, and for staging and followup. This review first considers the biological characteristics of FDG and then discusses methodological considerations regarding its use. Clinical indications are considered, and the results achieved in respect of various organs and tumour types are reviewed in depth. The review concludes with a brief consideration of the ways in which clinical PET might be improved.

show abstract

Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation?

Abstract: Our data indicate that PET may be of clinical value in predicting response to chemotherapy in patients with locally advanced breast cancer and/or metastatic disease earlier than any other method used.

Cited by 226 publications

References 16 publications

Response to Therapy in Breast Cancer

Response to Therapy in Breast Cancer

Early Prediction of Response to Chemotherapy and Survival in Malignant Pleural Mesothelioma Using a Novel Semiautomated 3-Dimensional Volume-Based Analysis of Serial 18F-FDG PET Scans

Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose

Contact Info

Product

Resources

About