title: Optical imaging of breast cancer oxyhemoglobin flare correlates with neoadjuvant chemotherapy response one day after starting treatment.
abstract: Approximately 8-20% of breast cancer patients receiving neoadjuvant chemotherapy fail to achieve a measurable response and endure toxic side effects without benefit. Most clinical and imaging measures of response are obtained several weeks after the start of therapy. Here, we report that functional hemodynamic and metabolic information acquired using a noninvasive optical imaging method on the first day after neoadjuvant chemotherapy treatment can discriminate nonresponding from responding patients. Diffuse optical spectroscopic imaging was used to measure absolute concentrations of oxyhemoglobin, deoxyhemoglobin, water, and lipid in tumor and normal breast tissue of 24 tumors in 23 patients with untreated primary breast cancer. Measurements were made before chemotherapy, on day 1 after the first infusion, and frequently during the first week of therapy. Various multidrug, multicycle regimens were used to treat patients. Diffuse optical spectroscopic imaging measurements were compared with final postsurgical pathologic response. A statistically significant increase, or flare, in oxyhemoglobin was observed in partial responding (n = 11) and pathologic complete responding tumors (n = 8) on day 1, whereas nonresponders (n = 5) showed no flare and a subsequent decrease in oxyhemoglobin on day 1. Oxyhemoglobin flare on day 1 was adequate to discriminate nonresponding tumors from responding tumors. Very early measures of chemotherapy response are clinically convenient and offer the potential to alter treatment strategies, resulting in improved patient outcomes.
authors.affiliation: Laser Microbeam and Medical Program, Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA 92617, USA.
authors.forename: Darren
authors.initials: D
authors.lastname: Roblyer
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ueda
authors.forename: Albert
authors.initials: A
authors.lastname: Cerussi
authors.forename: Wendy
authors.initials: W
authors.lastname: Tanamai
authors.forename: Amanda
authors.initials: A
authors.lastname: Durkin
authors.forename: Rita
authors.initials: R
authors.lastname: Mehta
authors.forename: David
authors.initials: D
authors.lastname: Hsiang
authors.forename: John A
authors.initials: JA
authors.lastname: Butler
authors.forename: Christine
authors.initials: C
authors.lastname: McLaren
authors.forename: Wen-Pin
authors.initials: WP
authors.lastname: Chen
authors.forename: Bruce
authors.initials: B
authors.lastname: Tromberg
mesh_terms: D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D010108:Oxyhemoglobins / Q000032:analysis*
chemical_list: D010108:Oxyhemoglobins