Role of 2-[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the early assessment of response to chemotherapy in metastatic breast cancer patients

Clin Breast Cancer. 2000 Jul;1(2):156-61; discussion 162-3. doi: 10.3816/cbc.2000.n.014.

Abstract

We investigated the role of 2-[18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the early evaluation of response to chemotherapy in metastatic breast cancer patients. Breast cancer patients who received an epirubicin/paclitaxel--containing regimen as first-line treatment for metastatic disease were included in this study. A PET study was performed within 1 week before the start of treatment, at day 8 after the first course, and at the end of the planned program of chemotherapy. Tumor response was determined clinically and radiographically every 2 courses of treatment. Thirteen patients with metastatic breast cancer who were referred for treatment protocols with gemcitabine/epirubicin/paclitaxel or epirubicin/paclitaxel chemotherapy regimens were included in this study. All metastatic sites were easily visualized on the baseline FDG-PET images, obtained 50 to 60 minutes after tracer injection. Nine patients who completed the planned courses of chemotherapy and the FDG-PET studies were available for analysis. In the six patients who achieved a response to treatment, median glucose standard uptake value (SUV) (semiquantitative analysis) was 7.65 (range, 3.4-12.3) at baseline, 5.7 (range, 2.8-7.6) at day 8 after the first course, and 1.2 (range, 0.99-1.3) at the end of the 6 planned courses of chemotherapy. Three patients who obtained a stable disease as best response had no significant decrease in tumor glucose SUV compared to baseline levels. Qualitative visual analysis in the six responding patients showed a decrease in delineation of tumor mass from background activity soon after the first course, while the nonresponding patients had no significant modification from basal levels. Semiquantitative FDG-PET scanning of metastatic breast cancer sites showed a rapid and significant decrease in tumor glucose metabolism soon after the first course of treatment in patients who achieved a response to first-line chemotherapy. On the contrary, no significant decrease was observed in nonresponding patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / pathology*
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives*
  • Drug Monitoring / methods*
  • Drug Monitoring / standards
  • Epirubicin / administration & dosage
  • Female
  • Fluorodeoxyglucose F18*
  • Glucose / metabolism
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary
  • Paclitaxel / administration & dosage
  • Predictive Value of Tests
  • Radiopharmaceuticals*
  • Remission Induction
  • Soft Tissue Neoplasms / diagnosis*
  • Soft Tissue Neoplasms / drug therapy*
  • Soft Tissue Neoplasms / metabolism
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / secondary
  • Survival Analysis
  • Time Factors
  • Tomography, Emission-Computed / methods*
  • Tomography, Emission-Computed / standards
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Deoxycytidine
  • Fluorodeoxyglucose F18
  • Epirubicin
  • gemcitabine
  • Glucose
  • Paclitaxel