Seban Romain-David, Champion Laurence, De Moura Alexandre, Lerebours Florence, Loirat Delphine, Pierga Jean-Yves, Djerroudi Lounes, Genevee Thomas, Huchet Virginie, Jehanno Nina, Bidard Francois-Clement, Buvat Irene
Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210, Saint-Cloud, France.
Laboratoire d'Imagerie Translationnelle en Oncologie, Inserm U1288, PSL University, Institut Curie, Paris Saclay University, 91400, Orsay, France.
Eur J Nucl Med Mol Imaging. 2025 Jan;52(2):708-718. doi: 10.1007/s00259-024-06929-x. Epub 2024 Oct 7.
This study aimed to evaluate the association between pretreatment [18F]FDG PET/CT-derived biomarkers and outcomes in metastatic breast cancer (mBC) patients treated with antibody-drug conjugates (ADCs) Sacituzumab Govitecan (SG) and Trastuzumab Deruxtecan (T-DXd).
A retrospective bicentric analysis was conducted on triple-negative mBC (mTNBC) patients treated with SG and HER2-low mBC patients treated with T-DXd, who underwent [18F]FDG PET/CT scans before therapy. Key biomarkers, including maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV) and maximum tumor dissemination (Dmax), were measured. Their prognostic value for progression-free survival (PFS) and overall survival (OS) was assessed using Cox models and Kaplan-Meier curves.
128 patients were included: 71 mTNBC treated with SG and 57 HR-positive and -negative HER2-low mBC treated with T-DXd. Median follow-up was 12.9 months. In the SG cohort, median PFS and OS were 4.8 and 8.9 months, respectively. High Dmax (HR 2.1, 95% CI 1.1-4.3) and high TMTV (HR 2.9, 95% CI 1.2-6.6) were independently associated with shorter OS. In the T-DXd cohort, median PFS and OS were 5.8 and 9.0 months, respectively. High Dmax (HR 2.1, 95% CI 1.2-3.9) and high TMTV (HR 2.4, 95% CI 1.0-6.5) independently correlated with shorter PFS and shorter OS, respectively.
Pretreatment [18F]FDG PET/CT-derived biomarkers, namely TMTV and Dmax, have significant prognostic value in patients with mTNBC and HER2-low mBC treated with SG and T-DXd. These biomarkers improve prognostic prediction and may optimize treatment strategies, warranting their clinical use, but larger studies are needed to validate these findings.
本研究旨在评估在接受抗体药物偶联物（ADC）赛托珠单抗戈维汀（SG）和曲妥珠单抗德鲁昔康（T-DXd）治疗的转移性乳腺癌（mBC）患者中，治疗前[18F]氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（[18F]FDG PET/CT）衍生的生物标志物与预后之间的关联。
对接受SG治疗的三阴性mBC（mTNBC）患者和接受T-DXd治疗的HER2低表达mBC患者进行回顾性双中心分析，这些患者在治疗前接受了[18F]FDG PET/CT扫描。测量了关键生物标志物，包括最大标准化摄取值（SUVmax）、总代谢肿瘤体积（TMTV）和最大肿瘤播散（Dmax）。使用Cox模型和Kaplan-Meier曲线评估它们对无进展生存期（PFS）和总生存期（OS）的预后价值。
纳入128例患者：71例接受SG治疗的mTNBC患者和57例接受T-DXd治疗的HR阳性和阴性HER2低表达mBC患者。中位随访时间为12.9个月。在SG队列中，中位PFS和OS分别为4.8个月和8.9个月。高Dmax（风险比[HR] 2.1，95%置信区间[CI] 1.1 - 4.3）和高TMTV（HR 2.9，95% CI 1.2 - 6.6）与较短的OS独立相关。在T-DXd队列中，中位PFS和OS分别为5.8个月和9.0个月。高Dmax（HR 2.1，95% CI 1.2 - 3.9）和高TMTV（HR 2.4，95% CI 1.0 - 6.5）分别与较短的PFS和较短的OS独立相关。
治疗前[18F]FDG PET/CT衍生的生物标志物，即TMTV和Dmax，在接受SG和T-DXd治疗的mTNBC和HER2低表达mBC患者中具有显著的预后价值。这些生物标志物改善了预后预测，可能优化治疗策略，值得临床应用，但需要更大规模的研究来验证这些发现。
