Utility of technetium-99m methoxyisobutyl isonitrile uptake analysis for prediction of the response to chemotherapy in advanced and relapsed breast cancer.
BACKGROUND
Technetium-99m methoxyisobutyl isonitrile (Tc-SESTAMIBI) is a substrate of P-glycoprotein and multidrug-resistance associated protein in drug-resistant cells. To assess the clinical effectiveness of Tc-SESTAMIBI for predicting the chemotherapy response to treatment with anthracyclines and vinca alkaloids, we retrospectively evaluated the relationship between the accumulation of Tc-SESTAMIBI and the tumor response.


METHODS
Thirteen patients, including 12 advanced cases and 1 relapsed case, were investigated, all of whom had been treated with anthracyclines or a vinca alkaloid regimen. The accumulation of Tc-SESTAMIBI was compared at 10 min and 2 h after Tc-SESTAMIBI administration. The relationship between the accumulation of Tc-SESTAMIBI and the tumor response following treatment with anthracyclines and vinca alkaloids was assessed.


RESULTS
Eight of 13 patients responded to treatment with anthracyclines and vinca alkaloids, whereas 5 patients did not respond to treatment. At 10 min, 6 (75.0% ) of the 8 responding patients had a high accumulation of Tc-SESTAMIBI, whereas 4 (80.0% ) of the 5 non-responding patients had a low accumulation of Tc-SESTAMIBI. The overall predictive value was 76.9%. The relationship was not statistically significant (Fisher's test). The difference in the decrease of accumulation of Tc-SESTAMIBI between 10 min and 2 h was not associated with tumor response to treatment in 6 of the responding patients with high accumulation. Two false negative cases and one false positive case were observed, suggesting the presence of another factor contributing to drug sensitivity in tumor response, such as apoptosis-related genes.


CONCLUSIONS
Assessment of the initial accumulation of Tc-SESTAMIBI can be a predictive marker of tumor response to treatment with anthracyclines and vinca alkaloids in patients with advanced and relapsed breast cancer. Further studies are required to explore other factors involved in the tumor response to treatment with anthracyclines and vinca alkaloids.
Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan. rkim@hiroshima-u.ac.jp
Ryungsa
R
Kim
Akihiko
A
Osaki
Toshihiro
T
Hirai
Tetsuya
T
Toge
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D016896:Treatment Outcome; D014748:Vinca Alkaloids / Q000008:administration & dosage
D000903:Antibiotics, Antineoplastic; D014748:Vinca Alkaloids; D017256:Technetium Tc 99m Sestamibi