FDG positron emission tomography imaging and ctDNA detection as an early dynamic biomarker of everolimus efficacy in advanced luminal breast cancer.
Andrea GombosDavid VenetLieveke AmeyePeter VuylstekePatrick NevenVincent RichardFran Ois P DuhouxJean-Francois LaesFrançoise RotheChristos SotiriouMarianne PaesmansAhmad AwadaThomas GuiotPatrick FlamenMartine Piccart-GebhartMichail IgnatiadisGéraldine GebhartPublished in: NPJ breast cancer (2021)
Biomarkers to identify patients without benefit from adding everolimus to endocrine treatment in metastatic breast cancer (MBC) are needed. We report the results of the Pearl trial conducted in five Belgian centers assessing 18F-FDG-PET/CT non-response (n = 45) and ctDNA detection (n = 46) after 14 days of exemestane-everolimus (EXE-EVE) to identify MBC patients who will not benefit. The metabolic non-response rate was 66.6%. Median PFS in non-responding patients (using as cut-off 25% for SUVmax decrease) was 3.1 months compared to 6.0 months in those showing response (HR: 0.77, 95% CI: 0.40-1.50, p = 0.44). The difference was significant when using a "post-hoc" cut-off of 15% (PFS 2.2 months vs 6.4 months). ctDNA detection at D14 was associated with PFS: 2.1 months vs 5.0 months (HR-2.5, 95% CI: 1.3-5.0, p = 0.012). Detection of ctDNA and/or the absence of 18F-FDG-PET/CT response after 14 days of EXE-EVE identifies patients with a low probability of benefiting from treatment. Independent validation is needed.
Keyphrases
- positron emission tomography
- end stage renal disease
- metastatic breast cancer
- chronic kidney disease
- computed tomography
- ejection fraction
- loop mediated isothermal amplification
- real time pcr
- label free
- prognostic factors
- clinical trial
- pet ct
- circulating tumor
- high resolution
- mass spectrometry
- photodynamic therapy
- combination therapy
- phase iii
- cell free