Currin Erin, Peterson Lanell M, Schubert Erin K, Link Jeanne M, Krohn Kenneth A, Livingston Robert B, Mankoff David A, Linden Hannah M
University of Washington/Seattle Cancer Care Alliance, Seattle, Washington
University of Pennsylvania, Philadelphia, Pennsylvania
J Natl Compr Canc Netw. 2016 Feb;14(2):144-7. doi: 10.6004/jnccn.2016.0017.
Changes in estrogen receptor (ER) expression over the course of therapy may affect response to endocrine therapy. However, measuring temporal changes in ER expression requires serial biopsies, which are impractical and poorly tolerated by most patients. Functional ER imaging using (18)F-fluoroestradiol (FES)-PET provides a noninvasive measure of regional ER expression and is ideally suited to serial studies. Additionally, lack of measurable FES uptake in metastatic sites of disease predict tumor progression in patients with ER-positive primary tumors treated with endocrine therapy. This report presents a case of restored sensitivity to endocrine therapy in a patient with bone-dominant breast cancer who underwent serial observational FES-PET imaging over the course of several treatments at our center, demonstrating the temporal heterogeneity of regional ER expression. Although loss and restoration of endocrine sensitivity in patients who have undergone prior hormonal and cytotoxic treatments has been reported, this is, to our knowledge, the first time the accompanying changes in ER expression have been documented by molecular imaging.
治疗过程中雌激素受体（ER）表达的变化可能会影响内分泌治疗的反应。然而，测量ER表达的时间变化需要进行系列活检，这对大多数患者来说不切实际且耐受性差。使用（18）F-氟雌二醇（FES）-PET进行功能性ER成像可提供区域ER表达的非侵入性测量，非常适合进行系列研究。此外，在接受内分泌治疗的ER阳性原发性肿瘤患者中，疾病转移部位缺乏可测量的FES摄取预示着肿瘤进展。本报告介绍了一例以骨为主的乳腺癌患者，在我们中心接受多次治疗期间进行了系列观察性FES-PET成像，显示出区域ER表达的时间异质性，该患者对内分泌治疗恢复了敏感性。虽然此前已有报道称接受过激素和细胞毒性治疗的患者内分泌敏感性会丧失和恢复，但据我们所知，这是首次通过分子成像记录伴随的ER表达变化。
