Wong Keith, Sheehan-Dare Gemma, Nguyen Andrew, Ho Bao, Liu Victor, Lee Jonathan, Brown Lauren, Dear Rachel, Chan Lyn, Sharma Shikha, Malaroda Alessandra, Smith Isabelle, Lim Elgene, Emmett Louise
Department of Theranostics and Nuclear Medicine, St Vincent's Hospital, 390 Victoria Street, Sydney, NSW 2010, Australia.
St Vincent's Clinical School, University of New South Wales, Sydney, NSW 2010, Australia.
Pharmaceuticals (Basel). 2022 Jun 22;15(7):772. doi: 10.3390/ph15070772.
Breast cancers are most frequently oestrogen receptor (ER) and progesterone receptor (PR) positive and [18F]Fluorodeoxyglucose PET-CT (FDG) has lower sensitivity for these subtypes. The gastrin-releasing peptide receptor (GRPR) is overexpressed in ER+/PR+ breast cancers. This study assessed the safety and potential of [64Cu]Cu-Sarcophagine (SAR)-Bombesin PET/CT (BBN) in re-staging metastatic ER+/PR+/human epidermal growth-factor-2-negative (HER2-) breast cancer. Seven patients with metastatic ER+/PR+/HER2- breast cancer undergoing staging underwent [64Cu]Cu-SAR-BBN PET-CT. Bloods, vital signs and electrocardiogram, blood tracer-clearance and dosimetry were undertaken. GRPR status was assessed in available metastatic biopsy samples. Staging with conventional imaging ([18F]FDG, bone scan and diagnostic CT) was within 3 weeks of [64Cu]Cu-SAR-BBN PET/CT. PET scans were assessed visually and quantitatively. Seven patients underwent imaging. One of the seven had de-novo metastatic breast cancer and six of the seven recurrent metastatic disease. Two of the seven had lobular subtype. No adverse events were reported. All seven patients were positive on conventional imaging (six of seven on FDG). [64Cu]Cu-SAR-BBN imaging was positive in five of the seven. Both [64Cu]Cu-SAR-BBN-negative patients had disease identified on [18F]FDG. One patient was [64Cu]Cu-SAR-BBN positive/[18F]FDG negative. Four of seven patients were [64Cu]Cu-SAR-BBN positive/[18F]FDG positive. In these four, mean SUVmax was higher for [64Cu]Cu-SAR-BBN than [18F]FDG (SUVmax 15 vs. 12). In the classical lobular subtype (two of seven), [64Cu]Cu-SAR-BBN was more avid compared to [18F]FDG (SUVmax 20 vs. 11, and 20 vs. <3). Dosimetry calculations estimated whole-body effective dose for 200 MBq of [64Cu]Cu-SAR-BBN to be 1.9 mSv. [64Cu]Cu-SAR-BBN PET/CT appears safe and may have diagnostic value in metastatic ER+/PR+/HER2- breast cancer, particularly the lobular subtype. Further evaluation is warranted.
乳腺癌最常见的是雌激素受体（ER）和孕激素受体（PR）阳性，而[18F]氟脱氧葡萄糖PET-CT（FDG）对这些亚型的敏感性较低。胃泌素释放肽受体（GRPR）在ER+/PR+乳腺癌中过度表达。本研究评估了[64Cu]铜-肌氨酸（SAR）-蛙皮素PET/CT（BBN）对转移性ER+/PR+/人表皮生长因子-2阴性（HER2-）乳腺癌再分期的安全性和潜力。7例接受分期的转移性ER+/PR+/HER2-乳腺癌患者接受了[64Cu]铜-SAR-BBN PET-CT检查。进行了血液检查、生命体征和心电图检查、血液示踪剂清除和剂量测定。在可用的转移性活检样本中评估GRPR状态。采用传统成像（[18F]FDG、骨扫描和诊断性CT）进行分期在[64Cu]铜-SAR-BBN PET/CT检查的3周内。PET扫描进行了视觉和定量评估。7例患者接受了成像检查。7例中有1例为新发转移性乳腺癌，7例中有6例为复发性转移性疾病。7例中有2例为小叶型亚型。未报告不良事件。所有7例患者在传统成像中均为阳性（7例中有6例在FDG检查中为阳性）。7例中有5例[64Cu]铜-SAR-BBN成像为阳性。2例[64Cu]铜-SAR-BBN阴性患者在[18F]FDG检查中发现有疾病。1例患者[64Cu]铜-SAR-BBN阳性/[18F]FDG阴性。7例患者中有4例[64Cu]铜-SAR-BBN阳性/[18F]FDG阳性。在这4例中，[64Cu]铜-SAR-BBN的平均SUVmax高于[18F]FDG（SUVmax分别为15和12）。在经典小叶型亚型（7例中有2例）中，[64Cu]铜-SAR-BBN比[18F]FDG摄取更明显（SUVmax分别为20和11，以及20和<3）。剂量测定计算估计200 MBq的[64Cu]铜-SAR-BBN的全身有效剂量为1.9 mSv。[64Cu]铜-SAR-BBN PET/CT似乎是安全的，对转移性ER+/PR+/HER2-乳腺癌，特别是小叶型亚型可能具有诊断价值。有必要进行进一步评估。
