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Response evaluation with 18F-FDG PET/CT in metastatic breast cancer patients treated with Palbociclib: first experience in clinical practice

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Abstract

Objective

Palbociclib is a cyclin-dependent kinase 4/6 inhibitor recently approved for treatment in advanced or metastatic breast cancer (BC) patients. The use of 18F-FDG PET/CT for chemo/endocrine therapy response assessment in BC patients is well reported in the literature, but no studies have evaluated its role for assessing Palbociclib efficacy in clinical practice. Our study aimed to evaluate the potential role of 18F-FDG PET/CT in this setting.

Methods

In 12 metastatic BC patients (mean age = 62 ± 10 years) treated with Palbociclib plus endocrine therapy and who underwent a baseline and post-therapy 18F-FDG PET/CT, we retrospectively compared the Metabolic Response Evaluation (MRE, based on PET/CT) to the Standard Response Evaluation (SRE, based on clinico-laboratory and morphological data); we also assessed the influence of additional PET/CT information on the patients’ management.

Results

Compared to SRE, MRE increased the proportion of patients classified with progressive disease from 25 to 50% and differed from SRE in 8/12 patients: 3/8 shifted from stable disease or undetermined response to metabolic progression (more unfavorable category), 4/8 from stable disease to partial or complete metabolic response, and 1/8 from partial response to complete metabolic response (more favorable category). Additional PET/CT information led to a change in patients’ management in 3/12 (25%) patients.

Conclusion

In BC patients treated with Palbociclib, additional 18F-FDG PET/CT information seems clinically useful, with respect to personalized management, to early intercept patients who should discontinue Palbociclib because of progressive disease and to select patients requiring a strict monitoring of additional metabolic findings. Further studies are needed to confirm these preliminary results.

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References

  1. Hoste G, Punie K, Wildiers H, Beuselinck B, Lefever I, Van Nieuwenhuysen E, et al. Palbociclib in highly pretreated metastatic ER-positive HER2-negative breast cancer. Breast Cancer Res Treat. 2018. https://doi.org/10.1007/s10549-018-4827-6.

    Article  PubMed  Google Scholar 

  2. Rugo HS, Rumble RB, Macrae E, Barton DL, Connolly HK, Dickler MN, et al. Endocrine therapy for hormone receptor–positive metastatic breast cancer: American Society of Clinical Oncology Guideline. J Clin Oncol. 2016;34:3069–103.

    Article  PubMed  CAS  Google Scholar 

  3. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Summary_for_the_public/human/003853/WC500217199.pdf. Accessed Dec 2018.

  4. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm549978.htm. Accessed Dec 2018.

  5. Turner NC, Ro J, André F, Loi S, Verma S, Iwata H, et al. Palbociclib in hormone-receptor-positive advanced breast cancer. N Engl J Med. 2015;373:209–19.

    Article  PubMed  CAS  Google Scholar 

  6. Fry DW, Harvey PJ, Keller PR, Elliott WL, Meade M, Trachet E, et al. Specific inhibition of cyclin-dependent kinase 4/6 by PD 0332991 and associated antitumor activity in human tumor xenografts. Mol Cancer Ther. 2004;3:1427–38.

    PubMed  CAS  Google Scholar 

  7. Toogood PL, Harvey PJ, Repine JT, Sheehan DJ, VanderWel SN, Zhou H, et al. Discovery of a potent and selective inhibitor of cyclin-dependent kinase 4/6. J Med Chem. 2005;48:2388–406.

    Article  PubMed  CAS  Google Scholar 

  8. Mangini NS, Wesolowski R, Ramaswamy B, Lustberg MB, Berger MJ. Palbociclib: a novel cyclin-dependent kinase inhibitor for hormone receptor–positive advanced breast cancer. Ann Pharmacother. 2015;49:1252–60.

    Article  PubMed  CAS  Google Scholar 

  9. Turner NC, Finn RS, Martin M, Im SA, DeMichele A, Ettl J, et al. Clinical considerations of the role of palbociclib in the management of advanced breast cancer patients with and without visceral metastases. Ann Oncol. 2018;29:669–80.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Lheureux S, Denoyelle C, Ohashi PS, De Bono JS, Mottaghy FM. Molecularly targeted therapies in cancer: a guide for the nuclear medicine physician. Eur J Nucl Med Mol Imaging. 2017;44(Suppl 1):41–54.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Contractor KB, Aboagye EO. Monitoring predominantly cytostatic treatment response with 18F-FDG PET. J Nucl Med. 2009;50(Suppl 1):97S–105S.

    Article  PubMed  CAS  Google Scholar 

  12. Evangelista L, Cervino AR. Nuclear imaging and early breast cancer detection. Curr Radiopharm. 2014;7:29–35.

    Article  PubMed  CAS  Google Scholar 

  13. Humbert O, Cochet A, Coudert B, Berriolo-Riedinger A, Kanoun S, Brunotte F, et al. Role of positron emission tomography for the monitoring of response to therapy in breast cancer. Oncologist. 2015;20:94–104.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Yeruva SLH, Javadi MS, Stearns V. Complete response to single-agent palbociclib in metastatic breast cancer: a case report. Clin Breast Cancer. 2018;18:e277–80.

    Article  PubMed  Google Scholar 

  15. Dhakal A, Matthews CM, Levine EG, Salerno KE, Zhang F, Takabe K, et al. Efficacy of palbociclib combinations in hormone receptor-positive metastatic breast cancer patients after prior everolimus treatment. Clin Breast Cancer. 2018. https://doi.org/10.1016/j.clbc.2018.04.015.

    Article  PubMed  Google Scholar 

  16. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999;35:1773–82.

    Article  PubMed  CAS  Google Scholar 

  17. Berger ML, Lipset C, Gutteridge A, Axelsen K, Subedi P, Madigan D. Optimizing the leveraging of real-world data to improve the development and use of medicines. Value Health. 2015;18:127–30.

    Article  PubMed  Google Scholar 

  18. Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R. Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol. 1993;11:2101–11.

    Article  PubMed  CAS  Google Scholar 

  19. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.

    Article  PubMed  CAS  Google Scholar 

  20. Cook GJ, Azad GK, Goh V. Imaging bone metastases in breast cancer: staging and response assessment. J Nucl Med. 2016;57(Suppl 1):27S–33S.

    Article  PubMed  CAS  Google Scholar 

  21. Avril S, Muzic RF Jr, Plecha D, Traughber BJ, Vinayak S, Avril N. 18F-FDG PET/CT for monitoring of treatment response in breast cancer. J Nucl Med. 2016;57(Suppl 1):34S-9S.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Nuclear Medicine Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy

    Silvia Taralli, Margherita Lorusso, Valentina Scolozzi & Maria Lucia Calcagni

  2. Nuclear Medicine Institute, Università Cattolica del Sacro Cuore, Rome, Italy

    Valentina Scolozzi & Maria Lucia Calcagni

  3. Radiation Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

    Valeria Masiello & Fabio Marazzi

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  1. Silvia Taralli
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  2. Margherita Lorusso
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  3. Valentina Scolozzi
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  4. Valeria Masiello
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  6. Maria Lucia Calcagni
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Correspondence to Silvia Taralli.

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Taralli, S., Lorusso, M., Scolozzi, V. et al. Response evaluation with 18F-FDG PET/CT in metastatic breast cancer patients treated with Palbociclib: first experience in clinical practice. Ann Nucl Med 33, 193–200 (2019). https://doi.org/10.1007/s12149-018-01323-8

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  • DOI: https://doi.org/10.1007/s12149-018-01323-8

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