Gui Xinyu, Liang Xu, Guo Xiaoyi, Yang Zhi, Song Guohong
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing 100142, People's Republic of China.
Oncologist. 2025 Jan 17;30(1). doi: 10.1093/oncolo/oyae188.
Patients with breast cancer exhibit heterogeneity in the expression of the human epithelial growth factor receptor 2 (HER2). Clinically, re-biopsying recurrent or metastatic lesions presents substantial challenges. This study aimed to evaluate the efficacy of HER2-targeted PET/CT imaging in identifying HER2 expression in breast cancer lesions and monitoring therapeutic responses.
This exploratory analysis used data from a prospective study that included adult patients with breast cancer who underwent both Al18F-NOTA-HER2-BCH and 18F-FDG PET/CT imaging at Beijing Cancer Hospital between June 2020 and July 2023 (NCT04547309).
Fifty-nine participants, with a median age of 55 years, were analyzed. Lesions imaged with HER2-targeted PET/CT before anti-HER2 therapy exhibited higher SUVmax values than after therapy in HER2 immunohistochemistry (IHC) 3 + lesions (19.9, 95% CI: 15.7-25.3 vs 9.8, 95% CI: 5.6-14.7; P = .006). A significant positive correlation was observed between SUVmax on HER2-targeted PET/CT and IHC before therapy (P = .034), with higher SUVmax values noted in lesions with positive HER2 pathology compared to those with negative HER2 status (17.9 ± 13.2 vs 1.1 ± 0.3; P = .007). HER2 expression heterogeneity was confirmed both between primary and metastatic lesions (22.9%) and among different metastatic sites (26.7%) as assessed by HER2-targeted PET/CT. A superior therapeutic response correlated with higher pretreatment SUVmax values. The HER2-targeted PET/CT procedure was well-tolerated by all patients.
HER2-targeted PET/CT imaging offers a practical, non-invasive, and quantitative approach for assessing HER2 status in breast cancer patients, facilitating the optimization and personalization of therapeutic strategies by oncologists.
乳腺癌患者的人表皮生长因子受体2（HER2）表达存在异质性。临床上，对复发或转移病灶进行再次活检面临诸多挑战。本研究旨在评估HER2靶向PET/CT成像在识别乳腺癌病灶中HER2表达及监测治疗反应方面的疗效。
本探索性分析使用了一项前瞻性研究的数据，该研究纳入了2020年6月至2023年7月在北京肿瘤医院接受Al18F-NOTA-HER2-BCH和18F-FDG PET/CT成像的成年乳腺癌患者（NCT04547309）。
分析了59名参与者，中位年龄为55岁。在HER2免疫组化（IHC）3+病灶中，抗HER2治疗前HER2靶向PET/CT成像的病灶SUVmax值高于治疗后（19.9，95%CI：15.7 - 25.3 vs 9.8，95%CI：5.6 - 14.7；P = .006）。治疗前HER2靶向PET/CT的SUVmax与IHC之间存在显著正相关（P = .034），HER2病理阳性的病灶SUVmax值高于HER2状态阴性的病灶（17.9±13.2 vs 1.1±0.3；P = .007）。通过HER2靶向PET/CT评估，原发性和转移性病灶之间（22.9%）以及不同转移部位之间（26.7%）均证实存在HER2表达异质性。较好的治疗反应与治疗前较高的SUVmax值相关。所有患者对HER2靶向PET/CT检查耐受性良好。
HER2靶向PET/CT成像为评估乳腺癌患者的HER2状态提供了一种实用、非侵入性且定量的方法，有助于肿瘤学家优化治疗策略并实现个性化治疗。
