Identification of biomarkers including 18FDG-PET/CT for early prediction of response to neoadjuvant chemotherapy in Triple Negative Breast Cancer.
Fiche publication
Date publication
juin 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BRUNOTTE François, Pr COUTANT Charles, Pr FUMOLEAU Pierre, Pr COCHET Alexandre, Dr LORGIS Véronique, Dr DESMOULINS Isabelle, Dr CHARON-BARRA Céline
Tous les auteurs :
Humbert O, Riedinger JM, Charon-Barra C, Berriolo-Riedinger A, Desmoulins I, Lorgis V, Kanoun S, Coutant C, Fumoleau P, Cochet A, Brunotte F
Lien Pubmed
Résumé
PURPOSE: To investigate the value of the metabolic tumor response assessed with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinico-biological markers to predict pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in women with triple-negative breast cancer (TNBC). EXPERIMENTAL DESIGN: Fifty consecutive women with TNBC and an indication for NAC were prospectively included. Different pre-treatment clinical, biological and pathological biomarkers, including SBR grade, the Ki-67 proliferation index, androgen receptor expression, epidermal growth factor receptor (EGFR) and cytokeratin 5/6 staining, were assessed. Tumor glucose metabolism at baseline and its change after the first cycle of NAC (DeltaSUVmax) were assessed using FDG-PET. RESULTS: The pCR rate was 42%. High Ki-67 proliferation index (p=0.016), negative EGFR status (p=0.042), and high DeltaSUVmax (p=0.002) were significantly associated with pCR. In multivariate logistic regression, both negative EGFR status (Odds ratio=6.4; p=0.043) and high DeltaSUVmax (Odds ratio=7.1; p=0.014) were independent predictors of pCR. Using a threshold at -50%, tumor DeltaSUVmax predicted pCR with a negative, a positive predictive value and an accuracy of 79%, 70% and 75%, respectively. Combining a low DeltaSUVmax and positive EGFR status could predict non-pCR with an accuracy of 92%. CONCLUSIONS: It is important to define the chemosensitivity of TNBC to NAC early. Combining EGFR status and the metabolic response assessed with FDG-PET can help the physician to early predict the probability of achieving pCR or not. Given these results, the interest of response-guided tailoring of the chemotherapy might be tested in multicenter trials.
Référence
Clin Cancer Res. 2015 Jun 30. pii: clincanres.0384.2015.