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Publications

Journal Article Ahead of print

PubMed: 41339898 DOI: 10.1186/s13058-025-02156-w

18F-Fluorodeoxyglucose PET-CT evaluation after one course of neoadjuvant therapy fails to predict pCR in HER2 + BC patients: a prospective and multicentric French study.

Breast Cancer Res

Authors: M Chanchou, M A Mouret-Reynier, I Molnar, E Deshayes, V D'Hondt, K Bourahla, T Petit, S Bardet, C Levy, O Morel, P Augereau, C Rousseau, M Campone, J Monteil, L Venat-Bouvet, A Faye, V Benavent, F Cachin

Affiliations

  • UMR1240 IMoST. Médecine Nucléaire, Université Clermont Auvergne, CRLCC Jean Perrin, CRLCC Jean Perrin, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
  • CRLCC Jean Perrin. Oncologie Médicale, CRLCC Jean Perrin, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
  • CRLCC Jean Perrin. Recherche Clinique, CRLCC Jean Perrin, 58 rue Montalembert, 63011, Clermont-Ferrand, France.
  • Médecine nucléaire, institut du cancer de Montpellier (ICM), Université de Montpellier, 208, avenue des Apothicaires, 34298, Montpelliercedex 5, France.
  • Institut de recherche en cancérologie de Montpellier (IRCM), Université de Montpellier, institut régional du cancer de Montpellier (ICM), INSERM U1194, Montpellier, France.
  • Institut du Cancer de Montpellier (ICM), Oncologie Médicale, Université de Montpellier, 208, avenue des Apothicaires, 34298, MontpellierCedex 5, France.
  • Médecine nucléaire et imagerie moléculaire, Centre Paul-Strauss, 3, rue de la Porte-de-l'Hôpital, 67000, Strasbourg, France.
  • Oncologie médicale, Centre Paul Strauss, 3, rue de la Porte-de-l'Hôpital, 67000, Strasbourg, France.
  • Médecine nucléaire, Centre François-Baclesse, 3, avenue Général-Harris, 14076, Caen cedex 05, France.
  • Oncologie médicale, Centre François-Baclesse, 3, avenue Général-Harris, 14076, Caen cedex 05, France.
  • Médecine nucléaire, ICO Site Paul-Papin, 15, rue André-Bocquel, 49055, Angers cedex 2, France.
  • Oncologie Médicale, ICO Site Paul-Papin, 15, rue André-Bocquel, 49055, Angers cedex 2, France.
  • Médecine Nucléaire, Institut de Cancérologie de l'Ouest, Nantes Université, Univ Angers, INSERM, CNRS, F-44800CRCI2NA, F-44000, Saint-HerblainNantes, France.
  • Oncologie médicale, ICO Site René-Gauducheau, boulevard Jacques-Monod, 44805, Saint-Herblain cedex, France.
  • Médecine nucléaire, hôpital Dupuytren, CHU Limoges, 2, avenue Martin-Luther-King, 87042, Limoges cedex, France.
  • Oncologie médicale, hôpital Dupuytren, CHU Limoges, 2, avenue Martin-Luther-King, 87042, Limoges cedex, France.
  • Faculté de Médecine, Université Clermont Auvergne, 28 place Henri Dunant, 63000, Clermont-Ferrand, France.
  • R&D UNICANCER, 101, rue de Tolbiac, 75654, Paris Cedex 13, France.
  • UMR1240 IMoST. Médecine Nucléaire, Université Clermont Auvergne, CRLCC Jean Perrin, CRLCC Jean Perrin, 58 rue Montalembert, 63011, Clermont-Ferrand, France.

Abstract

BACKGROUND

18F-FDG PET-CT has emerged as a powerful imaging tool for initial staging and prognosis evaluation of patients with Breast Cancer (BC). However, previous studies are inconsistent on attributing a predictive value to the pathological Complete Response (pCR) determined by PET-CT. Our objective was to assess the association between pCR and 18F-FDG PET-CT findings in patients with HER2+ BC in neoadjuvant setting.

METHODS

We collected data from patients enrolled in the prospective and multicentric French clinical trial NeoTOP (NCT02339532) who underwent 18F-FDG PET-CT before and after their first course of neoadjuvant treatment (depending on topoisomerase 2-α amplification status: 3 cycles of FEC 100 followed by 3 cycles of Docetaxel + Trastuzumab + Pertuzumab or 6 cycles of Docetaxel + Carboplatin + Trastuzumab + Pertuzumab). PET response was evaluated with visual and quantitative methods, by measuring tumor uptake parameters (SUV and SUL maximal and mean values), then compared to the pCR established according to Chevallier's classification. \ RESULTS: Out of 86 patients, 45 had fully analysable PET and pathological data. pCR rate was 73.3%. Sensitivity and specificity of PET visual analysis for pCR diagnosis were 14.0-83.0% respectively. SUVmax baseline value was 12.0±7.2 and decreased by 55.0±21.0% after one cycle of treatment. Quantitative PET parameters and their variations were not significantly different between pCR and non-pCR patients (p>0.05 in all cases).

CONCLUSIONS

18F-FDG PET-CT before and after the first cycle of neoadjuvant treatment does not appear to be an effective tool to predict pCR in patients with HER2+ BC.

MeSH

Breast Neoplasms, Polymerase Chain Reaction, Neoplasms, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18, Neoadjuvant Therapy, Therapeutics