TY - JOUR
T1 - Evaluation of [ 89 Zr]trastuzumab-PET/CT in differentiating HER2-positive from HER2-negative breast cancer
AU - Dehdashti, Farrokh
AU - Wu, Ningying
AU - Bose, Ron
AU - Naughton, Michael J.
AU - Ma, Cynthia X.
AU - Marquez-Nostra, Bernadette V.
AU - Diebolder, Philipp
AU - Mpoy, Cedric
AU - Rogers, Buck E.
AU - Lapi, Suzanne E.
AU - Laforest, Richard
AU - Siegel, Barry A.
N1 - Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Purpose: To evaluate whether tumor uptake of [ 89 Zr]trastuzumab can distinguish HER2-positive from HER2-negative breast cancer. Methods: Women with HER2-positive (n = 34) and HER2-negative (n = 16) breast cancer underwent PET/CT 5 ± 2 days following [ 89 Zr]trastuzumab administration. HER2 status was determined based on immunohistochemistry and/or fluorescence in situ hybridization of primary or metastatic/recurrent tumor. Tumor [ 89 Zr]trastuzumab uptake was assessed qualitatively and semiquantitatively as maximum standardized uptake value (SUV max ), and correlated with HER2 status. Additionally, intrapatient heterogeneity of [ 89 Zr]trastuzumab uptake was evaluated. Results: On a per-patient basis, [ 89 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 max 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 max was significantly higher in HER2-positive compared to HER2-negative patients (p = 0.003). A cutoff SUV max 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 [ 89 Zr]trastuzumab uptake in 20% of patients with multiple lesions. Conclusions: [ 89 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.
AB - Purpose: To evaluate whether tumor uptake of [ 89 Zr]trastuzumab can distinguish HER2-positive from HER2-negative breast cancer. Methods: Women with HER2-positive (n = 34) and HER2-negative (n = 16) breast cancer underwent PET/CT 5 ± 2 days following [ 89 Zr]trastuzumab administration. HER2 status was determined based on immunohistochemistry and/or fluorescence in situ hybridization of primary or metastatic/recurrent tumor. Tumor [ 89 Zr]trastuzumab uptake was assessed qualitatively and semiquantitatively as maximum standardized uptake value (SUV max ), and correlated with HER2 status. Additionally, intrapatient heterogeneity of [ 89 Zr]trastuzumab uptake was evaluated. Results: On a per-patient basis, [ 89 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 max 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 max was significantly higher in HER2-positive compared to HER2-negative patients (p = 0.003). A cutoff SUV max 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 [ 89 Zr]trastuzumab uptake in 20% of patients with multiple lesions. Conclusions: [ 89 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.
KW - Breast cancer
KW - HER2
KW - Positron emission tomography
KW - Trastuzumab
KW - Zirconium-89
UR - http://www.scopus.com/inward/record.url?scp=85041899306&partnerID=8YFLogxK
U2 - 10.1007/s10549-018-4696-z
DO - 10.1007/s10549-018-4696-z
M3 - Article
C2 - 29442264
AN - SCOPUS:85041899306
SN - 0167-6806
VL - 169
SP - 523
EP - 530
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -