The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting
BackgroundCyclin-dependent kinase 4/6 (CDK4/6) inhibitors have demonstrated a survival benefit in the second-line treatment of patients with hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. However, identifying prognostic biomarkers remains a challe...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1454844/full |
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| author | Marcin Kubeczko Anna Polakiewicz-Gilowska Andrea D’Amico Olgierd Chrabański Katarzyna Świderska Ewa Chmielik Sławomir Blamek Daria Handkiewicz-Junak Michał Jarząb |
| author_facet | Marcin Kubeczko Anna Polakiewicz-Gilowska Andrea D’Amico Olgierd Chrabański Katarzyna Świderska Ewa Chmielik Sławomir Blamek Daria Handkiewicz-Junak Michał Jarząb |
| author_sort | Marcin Kubeczko |
| collection | DOAJ |
| description | BackgroundCyclin-dependent kinase 4/6 (CDK4/6) inhibitors have demonstrated a survival benefit in the second-line treatment of patients with hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. However, identifying prognostic biomarkers remains a challenge. Thus, we aimed to assess the prognostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) performed before CDK4/6 inhibitors initiation.MethodsThis single-center retrospective analysis comprised patients treated with CDK4/6 inhibitors in the second-line setting between 2018 and 2024, with FDG-PET-CT performed before CDK4/6 inhibitor initiation.ResultsThe study included 39 patients with a median age of 63 years (IQR 50 -71). Among them, 12 had de novo metastatic disease (30.8%), and 13 had oligometastatic disease (33.3%). Treatment distribution was as follows: 15 patients received palbociclib (38%), 19 ribociclib (49%), and five abemaciclib (13%). Most patients received fulvestrant (31 patients, 79%), whereas eight patients (21%) were treated with letrozole. The median progression-free survival (PFS) in all studied patients was 25.8 months. Notably, baseline SUVmax (maximum standardized uptake value) showed statistically and clinically significant differences. Patients in the low SUVmax group had a median PFS of 30.7 months, compared to 13.0 months for those in the high SUVmax group (p = 0.038). The 2-year PFS was 76.2% [95% CI 51.8% - 89.4%] for the low SUVmax group, contrasting with 22.3% [95% CI 4.0% - 49.9%] for the high SUVmax group. High SUVmax, poor performance status, and de novo metastatic disease were independent prognostic factors for PFS.ConclusionsFDG-PET-CT performed before cyclin-dependent kinase 4/6 inhibitor commencement is a valuable prognostic tool in hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. Patients with SUVmax less than 8.4 experienced extended progression-free survival compared to those with higher SUVmax. |
| format | Article |
| id | doaj-art-9d9e1f7a93a64468bcf194119069923b |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-9d9e1f7a93a64468bcf194119069923b2024-12-03T05:10:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-12-011410.3389/fonc.2024.14548441454844The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line settingMarcin Kubeczko0Anna Polakiewicz-Gilowska1Andrea D’Amico2Olgierd Chrabański3Katarzyna Świderska4Ewa Chmielik5Sławomir Blamek6Daria Handkiewicz-Junak7Michał Jarząb8Breast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandBreast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandDepartment of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandDepartment of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandBreast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandTumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandDepartment of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandDepartment of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandBreast Cancer Center, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, PolandBackgroundCyclin-dependent kinase 4/6 (CDK4/6) inhibitors have demonstrated a survival benefit in the second-line treatment of patients with hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. However, identifying prognostic biomarkers remains a challenge. Thus, we aimed to assess the prognostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) performed before CDK4/6 inhibitors initiation.MethodsThis single-center retrospective analysis comprised patients treated with CDK4/6 inhibitors in the second-line setting between 2018 and 2024, with FDG-PET-CT performed before CDK4/6 inhibitor initiation.ResultsThe study included 39 patients with a median age of 63 years (IQR 50 -71). Among them, 12 had de novo metastatic disease (30.8%), and 13 had oligometastatic disease (33.3%). Treatment distribution was as follows: 15 patients received palbociclib (38%), 19 ribociclib (49%), and five abemaciclib (13%). Most patients received fulvestrant (31 patients, 79%), whereas eight patients (21%) were treated with letrozole. The median progression-free survival (PFS) in all studied patients was 25.8 months. Notably, baseline SUVmax (maximum standardized uptake value) showed statistically and clinically significant differences. Patients in the low SUVmax group had a median PFS of 30.7 months, compared to 13.0 months for those in the high SUVmax group (p = 0.038). The 2-year PFS was 76.2% [95% CI 51.8% - 89.4%] for the low SUVmax group, contrasting with 22.3% [95% CI 4.0% - 49.9%] for the high SUVmax group. High SUVmax, poor performance status, and de novo metastatic disease were independent prognostic factors for PFS.ConclusionsFDG-PET-CT performed before cyclin-dependent kinase 4/6 inhibitor commencement is a valuable prognostic tool in hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. Patients with SUVmax less than 8.4 experienced extended progression-free survival compared to those with higher SUVmax.https://www.frontiersin.org/articles/10.3389/fonc.2024.1454844/fulladvanced breast cancer18Ffluorodeoxyglucose positron emission tomographypalbociclibribociclibabemaciclib |
| spellingShingle | Marcin Kubeczko Anna Polakiewicz-Gilowska Andrea D’Amico Olgierd Chrabański Katarzyna Świderska Ewa Chmielik Sławomir Blamek Daria Handkiewicz-Junak Michał Jarząb The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting Frontiers in Oncology advanced breast cancer 18Ffluorodeoxyglucose positron emission tomography palbociclib ribociclib abemaciclib |
| title | The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting |
| title_full | The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting |
| title_fullStr | The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting |
| title_full_unstemmed | The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting |
| title_short | The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting |
| title_sort | role of fdg pet assessment in patients with advanced breast cancer treated with cyclin dependent kinase 4 6 inhibitors in the second line setting |
| topic | advanced breast cancer 18Ffluorodeoxyglucose positron emission tomography palbociclib ribociclib abemaciclib |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1454844/full |
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