Pretreatment 18F‐FDG Uptake Heterogeneity Predicts Treatment Outcome of First‐Line Chemotherapy in Patients with Metastatic Triple‐Negative Breast Cancer

AbstractBackground.Intratumoral heterogeneity of 18F‐fluorodeoxyglucose (18F‐FDG) uptake in primary tumor has proven to be a surrogate marker for predicting treatment outcome in various tumors. However, the value of intraindividual heterogeneity in metastatic diseases remains unknown. The aim of this study was to evaluate pretreatment positron emission tomography/computed tomography (PET/CT) 18F‐FDG‐based heterogeneity for the prediction of first‐line treatment outcome in metastatic triple‐negative breast cancer (mTNBC).Materials and Methods.mTNBC patients from three clinical trials (NCT00601159, NCT01287624, and NCT02341911) with whole‐body 18F‐FDG PET/CT scan before first‐line gemcitabine/platinum were included. Heterogeneity index (HI) and the maximum of FDG uptake (MAX) across total metastatic lesions (‐T) on baseline PET/CT scans were assessed. HI was measured by MAX divided by the minimum FDG uptake across metastatic lesions. Optimal cutoffs were determined by time‐dependent receiver operator characteristics (ROC) analysis. Progression‐free survival (PFS) and overall survival (OS) were estimated by Kaplan‐Meier method and compared by log‐rank test.Results.A total of 42 mTNBC patients were included in this study. The median PFS of patients with high HI‐T (>1.9) and high MAX‐T (>10.5) was significantly shorter than patients with low HI‐T (
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Radiation Oncology, Breast Cancer, Cancer Imaging Source Type: research