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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 9/2007

01.09.2007 | Original Article

Imaging early changes in proliferation at 1 week post chemotherapy: a pilot study in breast cancer patients with 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography

verfasst von: Laura Kenny, R. Charles Coombes, David M. Vigushin, Adil Al-Nahhas, Sami Shousha, Eric O. Aboagye

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 9/2007

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Abstract

Purpose

3′-Deoxy-3′-[18F]fluorothymidine positron emission tomography ([18F]FLT-PET) has been developed for imaging cell proliferation and findings correlate strongly with the Ki-67 labelling index in breast cancer. The aims of this pilot study were to define objective criteria for [18F]FLT response and to examine whether [18F]FLT-PET can be used to quantify early response of breast cancer to chemotherapy.

Methods

Seventeen discrete lesions in 13 patients with stage II–IV breast cancer were scanned prior to and at 1 week after treatment with combination 5-fluorouracil, epirubicin and cyclophosphamide (FEC) chemotherapy. The uptake at 90 min (SUV90) and irreversible trapping (K i) of [18F]FLT were calculated for each tumour. The reproducibility of [18F]FLT-PET was determined in nine discrete lesions from eight patients who were scanned twice before chemotherapy. Clinical response was assessed at 60 days after commencing FEC.

Results

All tumours showed [18F]FLT uptake and this was reproducible in serial measurements (SD of mean % difference = 10.5% and 15.1%, for SUV90 and K i, respectively; test–retest correlation coefficient ≥0.97). Six patients had a significant clinical response (complete or partial) at day 60; these patients also had a significant reduction in [18F]FLT uptake at 1 week. Decreases in K i and SUV90 at 1 week discriminated between clinical response and stable disease (p = 0.022 for both parameters). In three patients with multiple lesions there was a mixed [18F]FLT response in primary tumours and metastases. [18F]FLT response generally preceded tumour size changes.

Conclusion

[18F]FLT-PET can detect changes in breast cancer proliferation at 1 week after FEC chemotherapy.
Literatur
1.
Zurück zum Zitat Surveillance E, End Results (SEER) Program (http://www.seer.cancer.gov). SEER*Stat Database: Incidence-SEER 17 Regs Public-Use, Nov 2005 Sub (1973–2003 varying), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2006, based on the November 2005 submission. Surveillance E, End Results (SEER) Program (http://​www.​seer.​cancer.​gov). SEER*Stat Database: Incidence-SEER 17 Regs Public-Use, Nov 2005 Sub (1973–2003 varying), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2006, based on the November 2005 submission.
2.
Zurück zum Zitat Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205–16.PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205–16.PubMedCrossRef
3.
Zurück zum Zitat Korn EL, Arbuck SG, Pluda JM, Simon R, Kaplan RS, Christian MC. Clinical trial designs for cytostatic agents: are new approaches needed? J Clin Oncol 2001;19:265–72.PubMed Korn EL, Arbuck SG, Pluda JM, Simon R, Kaplan RS, Christian MC. Clinical trial designs for cytostatic agents: are new approaches needed? J Clin Oncol 2001;19:265–72.PubMed
4.
Zurück zum Zitat Dowsett M, Archer C, Assersohn L, Gregory RK, Ellis PA, Salter J, et al. Clinical studies of apoptosis and proliferation in breast cancer. Endocr Relat Cancer 1999;6:25–8.PubMedCrossRef Dowsett M, Archer C, Assersohn L, Gregory RK, Ellis PA, Salter J, et al. Clinical studies of apoptosis and proliferation in breast cancer. Endocr Relat Cancer 1999;6:25–8.PubMedCrossRef
5.
Zurück zum Zitat Ellis MJ, Coop A, Singh B, Tao Y, Llombart-Cussac A, Janicke F, et al. Letrozole inhibits tumor proliferation more effectively than tamoxifen independent of HER1/2 expression status. Cancer Res 2003;63:6523–31.PubMed Ellis MJ, Coop A, Singh B, Tao Y, Llombart-Cussac A, Janicke F, et al. Letrozole inhibits tumor proliferation more effectively than tamoxifen independent of HER1/2 expression status. Cancer Res 2003;63:6523–31.PubMed
6.
Zurück zum Zitat Ellis MJ, Rosen E, Dressman H, Marks J. Neoadjuvant comparisons of aromatase inhibitors and tamoxifen: pretreatment determinants of response and on-treatment effect. J Steroid Biochem Mol Biol 2003;86:301–7.PubMedCrossRef Ellis MJ, Rosen E, Dressman H, Marks J. Neoadjuvant comparisons of aromatase inhibitors and tamoxifen: pretreatment determinants of response and on-treatment effect. J Steroid Biochem Mol Biol 2003;86:301–7.PubMedCrossRef
7.
Zurück zum Zitat van Diest PJ, van der Wall E, Baak JP. Prognostic value of proliferation in invasive breast cancer: a review. J Clin Pathol 2004;57:675–81.PubMedCrossRef van Diest PJ, van der Wall E, Baak JP. Prognostic value of proliferation in invasive breast cancer: a review. J Clin Pathol 2004;57:675–81.PubMedCrossRef
8.
Zurück zum Zitat Vincent-Salomon A, Rousseau A, Jouve M, Beuzeboc P, Sigal-Zafrani B, Freneaux P, et al. Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy. Eur J Cancer 2004;40:1502–8.PubMedCrossRef Vincent-Salomon A, Rousseau A, Jouve M, Beuzeboc P, Sigal-Zafrani B, Freneaux P, et al. Proliferation markers predictive of the pathological response and disease outcome of patients with breast carcinomas treated by anthracycline-based preoperative chemotherapy. Eur J Cancer 2004;40:1502–8.PubMedCrossRef
9.
Zurück zum Zitat Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R. Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol 1993;11:2101–11.PubMed Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R. Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol 1993;11:2101–11.PubMed
10.
Zurück zum Zitat Weber WA, Ziegler SI, Thodtmann R, Hanauske AR, Schwaiger M. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med 1999;40:1771–7.PubMed Weber WA, Ziegler SI, Thodtmann R, Hanauske AR, Schwaiger M. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med 1999;40:1771–7.PubMed
11.
Zurück zum Zitat Dehdashti F, Flanagan FL, Mortimer JE, Katzenellenbogen JA, Welch MJ, Siegel BA. Positron emission tomographic assessment of “metabolic flare” to predict response of metastatic breast cancer to antiestrogen therapy. Eur J Nucl Med 1999;26:51–6.PubMedCrossRef Dehdashti F, Flanagan FL, Mortimer JE, Katzenellenbogen JA, Welch MJ, Siegel BA. Positron emission tomographic assessment of “metabolic flare” to predict response of metastatic breast cancer to antiestrogen therapy. Eur J Nucl Med 1999;26:51–6.PubMedCrossRef
12.
Zurück zum Zitat Spaepen K, Stroobants S, Dupont P, Bormans G, Balzarini J, Verhoef G, et al. [18F]FDG PET monitoring of tumour response to chemotherapy: does [18F]FDG uptake correlate with the viable tumour cell fraction? Eur J Nucl Med Mol Imaging 2003;30:682–8.PubMedCrossRef Spaepen K, Stroobants S, Dupont P, Bormans G, Balzarini J, Verhoef G, et al. [18F]FDG PET monitoring of tumour response to chemotherapy: does [18F]FDG uptake correlate with the viable tumour cell fraction? Eur J Nucl Med Mol Imaging 2003;30:682–8.PubMedCrossRef
13.
Zurück zum Zitat van Waarde A, Cobben DC, Suurmeijer AJ, Maas B, Vaalburg W, de Vries EF, et al. Selectivity of 18F-FLT and 18F-FDG for differentiating tumor from inflammation in a rodent model. J Nucl Med 2004;45:695–700.PubMed van Waarde A, Cobben DC, Suurmeijer AJ, Maas B, Vaalburg W, de Vries EF, et al. Selectivity of 18F-FLT and 18F-FDG for differentiating tumor from inflammation in a rodent model. J Nucl Med 2004;45:695–700.PubMed
14.
Zurück zum Zitat Kenny LM, Vigushin DM, Al-Nahhas A, Osman S, Luthra SK, Shousha S, et al. Quantification of cellular proliferation in tumor and normal tissues of patients with breast cancer by [18F]fluorothymidine-positron emission tomography imaging: evaluation of analytical methods. Cancer Res 2005;65:10104–12.PubMedCrossRef Kenny LM, Vigushin DM, Al-Nahhas A, Osman S, Luthra SK, Shousha S, et al. Quantification of cellular proliferation in tumor and normal tissues of patients with breast cancer by [18F]fluorothymidine-positron emission tomography imaging: evaluation of analytical methods. Cancer Res 2005;65:10104–12.PubMedCrossRef
15.
Zurück zum Zitat Pio BS, Park CK, Pietras R, Hsueh WA, Satyamurthy N, Pegram MD, et al. Usefulness of 3′-[F-18]fluoro-3′-deoxythymidine with positron emission tomography in predicting breast cancer response to therapy. Mol Imaging Biol 2006;8:36–42.PubMedCrossRef Pio BS, Park CK, Pietras R, Hsueh WA, Satyamurthy N, Pegram MD, et al. Usefulness of 3′-[F-18]fluoro-3′-deoxythymidine with positron emission tomography in predicting breast cancer response to therapy. Mol Imaging Biol 2006;8:36–42.PubMedCrossRef
16.
Zurück zum Zitat Singletary SE, Allred C, Ashley P, Bassett LW, Berry D, Bland KI, et al. Revision of the American Joint Committee on Cancer staging system for breast cancer. J Clin Oncol 2002;20:3628–36.PubMedCrossRef Singletary SE, Allred C, Ashley P, Bassett LW, Berry D, Bland KI, et al. Revision of the American Joint Committee on Cancer staging system for breast cancer. J Clin Oncol 2002;20:3628–36.PubMedCrossRef
17.
Zurück zum Zitat Cleij MC, Steel CJ, Brady F, Ell PJ, Pike VW, Luthra SK. An improved synthesis of 3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT) and the fate of the precursor 2,3′-anhydro-5′-O-(4,4′-dimethoxytrityl)-thymidine. J Labelled Compounds Radiopharm 2001;44 Suppl 1:871–3. Cleij MC, Steel CJ, Brady F, Ell PJ, Pike VW, Luthra SK. An improved synthesis of 3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT) and the fate of the precursor 2,3′-anhydro-5′-O-(4,4′-dimethoxytrityl)-thymidine. J Labelled Compounds Radiopharm 2001;44 Suppl 1:871–3.
18.
Zurück zum Zitat Shields AF, Grierson JR, Muzik O, Stayanoff JC, Lawhorn-Crews JM, Obradovich JE, et al. Kinetics of 3′-deoxy-3′-[F-18]fluorothymidine uptake and retention in dogs. Mol Imaging Biol 2002;4:83–9.PubMedCrossRef Shields AF, Grierson JR, Muzik O, Stayanoff JC, Lawhorn-Crews JM, Obradovich JE, et al. Kinetics of 3′-deoxy-3′-[F-18]fluorothymidine uptake and retention in dogs. Mol Imaging Biol 2002;4:83–9.PubMedCrossRef
19.
Zurück zum Zitat Minn H, Zasadny KR, Quint LE, Wahl RL. Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]-fluoro-2-deoxy-D-glucose uptake at PET. Radiology 1995;196:167–73.PubMed Minn H, Zasadny KR, Quint LE, Wahl RL. Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]-fluoro-2-deoxy-D-glucose uptake at PET. Radiology 1995;196:167–73.PubMed
20.
Zurück zum Zitat Wells P, Gunn RN, Steel C, Ranicar AS, Brady F, Osman S, et al. 2-[11C]thymidine positron emission tomography reproducibility in humans. Clin Cancer Res 2005;11:4341–7.PubMedCrossRef Wells P, Gunn RN, Steel C, Ranicar AS, Brady F, Osman S, et al. 2-[11C]thymidine positron emission tomography reproducibility in humans. Clin Cancer Res 2005;11:4341–7.PubMedCrossRef
21.
Zurück zum Zitat Archer CD, Parton M, Smith IE, Ellis PA, Salter J, Ashley S, et al. Early changes in apoptosis and proliferation following primary chemotherapy for breast cancer. Br J Cancer 2003;89:1035–41.PubMedCrossRef Archer CD, Parton M, Smith IE, Ellis PA, Salter J, Ashley S, et al. Early changes in apoptosis and proliferation following primary chemotherapy for breast cancer. Br J Cancer 2003;89:1035–41.PubMedCrossRef
22.
Zurück zum Zitat Buck AK, Halter G, Schirrmeister H, Kotzerke J, Wurziger I, Glatting G, et al. Imaging proliferation in lung tumors with PET: 18F-FLT versus 18F-FDG. J Nucl Med 2003;44:1426–31.PubMed Buck AK, Halter G, Schirrmeister H, Kotzerke J, Wurziger I, Glatting G, et al. Imaging proliferation in lung tumors with PET: 18F-FLT versus 18F-FDG. J Nucl Med 2003;44:1426–31.PubMed
Metadaten
Titel
Imaging early changes in proliferation at 1 week post chemotherapy: a pilot study in breast cancer patients with 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography
verfasst von
Laura Kenny
R. Charles Coombes
David M. Vigushin
Adil Al-Nahhas
Sami Shousha
Eric O. Aboagye
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 9/2007
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0379-4

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