title: Identification of Biomarkers Including 18FDG-PET/CT for Early Prediction of Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer.
abstract: OBJECTIVE
  To investigate the value of the metabolic tumor response assessed with (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET), compared with clinicobiologic markers to predict pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in women with triple-negative breast cancer (TNBC).
  
  
  METHODS
  Fifty consecutive women with TNBC and an indication for NAC were prospectively included. Different pretreatment clinical, biologic, and pathologic biomarkers, including SBR grade, the Ki-67 proliferation index, androgen receptor expression, EGF receptor (EGFR), and cytokeratin 5/6 staining, were assessed. Tumor glucose metabolism at baseline and its change after the first cycle of NAC (ΔSUVmax) were assessed using FDG-PET.
  
  
  RESULTS
  The pCR rate was 42%. High Ki-67 proliferation index (P = 0.016), negative EGFR status (P = 0.042), and high ΔSUVmax (P = 0.002) were significantly associated with pCR. In multivariate logistic regression, both negative EGFR status (OR, 6.4; P = 0.043) and high ΔSUVmax (OR, 7.1; P = 0.014) were independent predictors of pCR. Using a threshold at -50%, tumor ΔSUVmax predicted pCR with a negative, a positive predictive value, and an accuracy of 79%, 70%, and 75%, respectively. Combining a low ΔSUVmax and positive EGFR status could predict non-pCR with an accuracy of 92%.
  
  
  CONCLUSIONS
  It is important to define the chemosensitivity of TNBC to NAC early. Combining EGFR status and the metabolic response assessed with FDG-PET can help the physician to early predict the probability of achieving pCR or not. Given these results, the interest of response-guided tailoring of the chemotherapy might be tested in multicenter trials. Clin Cancer Res; 21(24); 5460-8. ©2015 AACR.
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France. Université de Bourgogne, UMR CNRS 6306, Dijon, France. ohumbert@cgfl.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Humbert
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France. Departments of Biology and Pathology, Centre GF Leclerc, Dijon, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Riedinger
authors.affiliation: Departments of Biology and Pathology, Centre GF Leclerc, Dijon, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Charon-Barra
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France.
authors.forename: Alina
authors.initials: A
authors.lastname: Berriolo-Riedinger
authors.affiliation: Department of Medical Oncology, Centre GF Leclerc, Dijon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Desmoulins
authors.affiliation: Department of Medical Oncology, Centre GF Leclerc, Dijon, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Lorgis
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France. Université de Bourgogne, UMR CNRS 6306, Dijon, France. Imaging Department, CHU Le Bocage, Dijon, France.
authors.forename: Salim
authors.initials: S
authors.lastname: Kanoun
authors.affiliation: Department of Surgery, Centre GF Leclerc, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Department of Medical Oncology, Centre GF Leclerc, Dijon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Fumoleau
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France. Université de Bourgogne, UMR CNRS 6306, Dijon, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Cochet
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon, France. Université de Bourgogne, UMR CNRS 6306, Dijon, France. Imaging Department, CHU Le Bocage, Dijon, France.
authors.forename: François
authors.initials: F
authors.lastname: Brunotte
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015415:Biomarkers; D014408:Biomarkers, Tumor; D001706:Biopsy; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012372:ROC Curve; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality; D047368:Tumor Burden
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D019788:Fluorodeoxyglucose F18; D005947:Glucose