Identification of HER2-Positive Metastases in Patients with HER2-Negative Primary Breast Cancer by Using HER2-targeted 89Zr-Pertuzumab PET/CT.
Gary A UlanerJorge A CarrasquilloChristopher C RiedlRandy YehVaios HatzoglouDara S RossKomal JhaveriSarat ChandarlapatyDavid M HymanBrian M ZeglisSerge K LyashchenkoJason S LewisPublished in: Radiology (2020)
Background Human epidermal growth factor receptor 2 (HER2)-targeted therapies are successful in patients with HER2-positive malignancies; however, spatial and temporal heterogeneity of HER2 expression may prevent identification of optimal patients for these therapies. Purpose To determine whether imaging with the HER2-targeted PET tracer zirconium 89 (89Zr)-pertuzumab can depict HER2-positive metastases in women with HER2-negative primary breast cancer. Materials and Methods From January to June 2019, women with biopsy-proven HER2-negative primary breast cancer and biopsy-proven metastatic disease were enrolled in a prospective clinical trial (ClinicalTrials.gov NCT02286843) and underwent 89Zr-pertuzumab PET/CT for noninvasive whole-biopsy evaluation of potential HER2-positive metastases. 89Zr-pertuzumab-avid foci that were suspicious for HER2-positive metastases were tissue sampled and examined by pathologic analysis to document HER2 status. Results Twenty-four women (mean age, 55 years ± 11 [standard deviation]) with HER2-negative primary breast cancer were enrolled. Six women demonstrated foci at 89Zr-pertuzumab PET/CT that were suspicious for HER2-positive disease. Of these six women, three had biopsy-proven HER2-positive metastases, two had pathologic findings that demonstrated HER2-negative disease, and one had a fine-needle aspirate with inconclusive results. Conclusion Human epidermal growth factor receptor 2 (HER2)-targeted imaging with zirconium 89-pertuzumab PET/CT was successful in detecting HER2-positive metastases in women with HER2-negative primary breast cancer. This demonstrates the ability of targeted imaging to identify patients for targeted therapies that might not otherwise be considered. © RSNA, 2020 Online supplemental material is available for this article. See the editorial by Mankoff and Pantel in this issue.
Keyphrases
- pet ct
- epidermal growth factor receptor
- positron emission tomography
- tyrosine kinase
- advanced non small cell lung cancer
- pet imaging
- clinical trial
- high resolution
- ultrasound guided
- fine needle aspiration
- endothelial cells
- squamous cell carcinoma
- newly diagnosed
- cancer therapy
- ejection fraction
- small cell lung cancer
- breast cancer risk
- metastatic breast cancer
- randomized controlled trial
- adipose tissue
- healthcare
- young adults
- mass spectrometry
- type diabetes
- patient reported outcomes
- social media
- locally advanced
- binding protein
- lymph node
- study protocol
- rectal cancer
- fluorescence imaging
- long non coding rna