18 F-FDG PET/CT findings and circulating tumor cell counts in the monitoring of systemic therapies for bone metastases from breast cancer

Ugo De Giorgi, Michal Mego, Eric M. Rohren, Ping Liu, Beverly C. Handy, James M. Reuben, Homer A. Macapinlac, Gabriel N. Hortobagyi, Massimo Cristofanilli, Naoto T. Ueno

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Abstract

Our objective was to compare the predictive significance of 18 F-FDG PET/CT findings and circulating tumor cell (CTC) count in patients with bone metastases from breast cancer treated with standard systemic therapy. Methods: Breast cancer patients with progressive bone-only metastatic disease without visceral metastases starting a new line of systemic therapy underwent 18 F-FDG PET/CT and had CTC counts determined before and during treatment. Disease status was reassessed by CTC count (≥5 vs. <5 CTC/7.5 mL of blood) and 18 F-FDG PET/CT approximately 2-4 mo after initiation of the new systemic therapy. Results: CTC counts at follow-up agreed with the 18 F-FDG PET/CT assessment in 43 (78%) of the 55 evaluable patients. Of the 12 patients with discordant CTC and 18 F-FDG PET/CT results, 8 (66%) had ≥5 CTCs, with no evidence of progressive disease at the time of the 18 F-FDG PET/CT study, whereas 4 (33%) had <5 CTCs, with evidence of progressive disease by 18 F-FDG PET/CT. 18 F-FDG PET/CT findings and follow-up CTC counts were found to be significantly associated with both progression-free survival (P = 0.02 and P < 0.0001, respectively) and overall survival (P = 0.02 and P = 0.01, respectively). In multivariate analysis, the 18 F-FDG PET/CT assessment remained as the only predictive factor for progression-free survival (P < 0.0001), whereas estrogen receptor status was the only predictive factor for overall survival (P = 0.01). Conclusion: 18 F-FDG PET/CT is a useful tool for therapeutic monitoring in patients with bone metastases from breast cancer. Prospective studies are needed to define the role of 18 F-FDG PET/CT and CTC in the setting of response discordance to establish bone-dominant disease as a tumor-response measurable disease. COPYRIGHT

Original languageEnglish (US)
Pages (from-to)1213-1218
Number of pages6
JournalJournal of Nuclear Medicine
Volume51
Issue number8
DOIs
StatePublished - Aug 1 2010

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Keywords

  • Bone metastases
  • Breast cancer
  • Circulating tumor cells
  • PET/CT
  • Therapeutic monitoring

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

De Giorgi, U., Mego, M., Rohren, E. M., Liu, P., Handy, B. C., Reuben, J. M., Macapinlac, H. A., Hortobagyi, G. N., Cristofanilli, M., & Ueno, N. T. (2010). 18 F-FDG PET/CT findings and circulating tumor cell counts in the monitoring of systemic therapies for bone metastases from breast cancer Journal of Nuclear Medicine, 51(8), 1213-1218. https://doi.org/10.2967/jnumed.110.076455