title: Prospective Clinical Trial of18F-Fluciclovine PET/CT for Determining the Response to Neoadjuvant Therapy in Invasive Ductal and Invasive Lobular Breast Cancers.
abstract: 18F-labeled 1-amino-3-fluorocyclobutane-1-carboxylic acid (18F-fluciclovine) is a leucine analog radiotracer that depicts amino acid transport into cells.18F-fluciclovine PET/CT visualizes malignancy, including prostate cancer, invasive ductal breast cancer, and invasive lobular breast cancer. Whether changes in18F-fluciclovine avidity reflect changes in tumor burden resulting from treatment has not been shown. In this prospective clinical trial (clinical trials.gov: NCT01864083), changes in18F-fluciclovine avidity after neoadjuvant therapy were compared to breast cancer therapy response, as determined by residual tumor burden on pathology, were evaluated.Methods:Twenty-four women with a new diagnosis of locally advanced invasive ductal breast cancer (n= 18) or invasive lobular breast cancer (n= 6) underwent18F-fluciclovine PET/CT before and after the completion of neoadjuvant systemic therapy. SUVmax, SUVmean, metabolic tumor volume, and total lesion avidity were obtained for the primary breast tumor, axillary lymph nodes, and extraaxillary lymph nodes on each examination and corrected for background18F-fluciclovine avidity. The relationship between changes in18F-fluciclovine avidity and the percentage of reduction of tumor on pathology was assessed with the Spearman rank correlation.Results:The median decrease in the corrected SUVmaxof the primary breast lesions was 99% (range, 33%-100%). The median reduction of tumor on pathology was 92% (range, 10%-100%). Changes in18F-fluciclovine avidity were strongly correlated with the percentage of reduction of tumor on pathology (Spearman ρ, 0.79; 95% CI, 0.56-0.90;P< 0.001).Conclusion:Changes in18F-fluciclovine avidity strongly correlated with the tumor response on pathology in this pilot study.
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York ulanerg@mskcc.org.|Department of Radiology, Weill Cornell Medical College, New York, New York.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ulaner
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldman
authors.affiliation: Department of Pathology, Weill Cornell Medical College, New York, New York.
authors.forename: Adriana
authors.initials: A
authors.lastname: Corben
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.|Radiochemistry and Molecular Imaging Probes Core Facility, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Serge K
authors.initials: SK
authors.lastname: Lyashchenko
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Mithat
authors.initials: M
authors.lastname: Gönen
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.|Department of Radiology, Weill Cornell Medical College, New York, New York.|Radiochemistry and Molecular Imaging Probes Core Facility, Memorial Sloan Kettering Cancer Center, New York, New York.|Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York; and.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Lewis
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Maura
authors.initials: M
authors.lastname: Dickler
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D002264:Carboxylic Acids; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D003503:Cyclobutanes; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D002264:Carboxylic Acids; D003503:Cyclobutanes; D019275:Radiopharmaceuticals; C117460:fluciclovine F-18
keywords: 18F-fluciclovine; PET/CT; ductal breast cancer; lobular breast cancer; response