Positron emission tomographic assessment of ?metabolic flare" to predict response of metastatic breast cancer to antiestrogen therapy

Dehdashti, Farrokh; Flanagan, Fidelma; Mortimer, Joanne; Katzenellenbogen, John A.; Welch, Michael J.; Siegel, Barry A.

doi:10.1007/s002590050359

Cited by 260 publications

(182 citation statements)

References 8 publications

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“…First, for tar geted therapies, tumors always change metabo lically earlier than their size changes. Second, for endocrine therapy, several studies have shown that an increase in tumor FDG uptake 7-10 days after initiating endocrine therapy is predictive of a good response [19][20]. This phenomenon can be ex plained by the fact that endocrine therapy has ini tial agonist effects before antagonist effects domi nate.…”

Section: Assessment Of Response To Therapymentioning

confidence: 99%

PET/CT Imaging for Monitoring Recurrence and Evaluating Response to Treatment in Breast Cancer

Lei¹,

Wang²,

Chen³

2016

Adv Clin Exp Med

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Section: Assessment Of Response To Therapymentioning

confidence: 99%

PET/CT Imaging for Monitoring Recurrence and Evaluating Response to Treatment in Breast Cancer

Lei¹,

Wang²,

Chen³

2016

Adv Clin Exp Med

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“…Thus, it is an early predictor of tumor sensitivity to endocrine therapy [75,76]. In contrast, because antiaromatase therapy lowers estradiol level and thus reduces the tumor agonist effect, responding patients shows an early drop in tumor FDG uptake after antiaromatase induction [77].…”

Section: Evaluation Of Response To Endocrine Therapymentioning

confidence: 99%

Role of Positron Emission Tomography for the Monitoring of Response to Therapy in Breast Cancer

et al. 2015

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This review considers the potential utility of positron emission tomography (PET) tracers in the setting of response monitoring in breast cancer, with a special emphasis on glucose metabolic changes assessed with 18 F-fluorodeoxyglucose (FDG). In the neoadjuvant setting of breast cancer, the metabolic response can predict the final complete pathologic response after the first cycles of chemotherapy. Because tumor metabolic behavior highly depends on cancer subtype, studies are ongoing to define the optimal metabolic criteria of tumor response in each subtype.The recent multicentric randomized AVATAXHER trial has suggested, in the human epidermal growth factor 2-positive subtype, a clinical benefit of early tailoring the neoadjuvant treatment in women with poor metabolic response after the first course of treatment. In the bone-dominant metastatic setting, there is increasing clinical evidence that FDG-PET/computed tomography (CT) is the most accurate imaging modality for assessment of the tumor response to treatment when both metabolic information and morphologic information are considered. Nevertheless, there is a need to define standardized metabolic criteria of response, including the heterogeneity of response among metastases, and to evaluate the costs and health outcome of FDG-PET/CT compared with conventional imaging. New non-FDG radiotracers highlighting specific molecular hallmarks of breast cancer cells have recently emerged in preclinical and clinical studies. These biomarkers can take into account the heterogeneity of tumor biology in metastatic lesions. They may provide valuable clinical information for physicians to select and monitor the effectiveness of novel therapeutics targeting the same molecular pathways of breast tumor. The Oncologist 2015;20:94-104 Implications for Practice:18 F-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is a molecular imaging exam. It can monitor breast cancer response to therapy earlier than the tumor shrinking observed with conventional imaging. This review focuses on the advantages and limits of FDG-PET for early determination of response, both in the neoadjuvant and metastatic settings. It discusses the different PET timing and metabolic criteria to define response that have been evaluated in previous studies. The development of new radiotracers of specific molecular pathways of breast cancer cells is also a challenging and promising research area to monitor the effectiveness of the new target treatments emerging in breast cancer.

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“…33,34 Similarly, inhibition of enzymatic activity can also be visualized by imaging probes that are substrates of specific enzymes. This approach has been used to monitor the inhibition of matrix metalloproteinase activity by activatable MRI probes that are cleaved by this enzyme.…”

Section: Measuring Target Inhibitionmentioning

confidence: 99%

Technology Insight: novel imaging of molecular targets is an emerging area crucial to the development of targeted drugs

et al. 2008

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SUMMARYTargeted drugs hold great promise for the treatment of malignant tumors; however, there are several challenges for efficient evaluation of these drugs in preclinical and clinical studies. These challenges include identifying the 'correct', biologically active concentration and dose schedule, selecting the patients likely to benefit from treatment, monitoring inhibition of the target protein or pathway, and assessing the response of the tumor to therapy. Although anatomic imaging will remain important, molecular imaging provides several new opportunities to make the process of drug development more efficient. Various techniques for molecular imaging that enable noninvasive and quantitative imaging are now available in the preclinical and clinical settings, to aid development and evaluation of new drugs for the treatment of cancer. In this Review, we discuss the integration of molecular imaging into the process of drug development and how molecular imaging can address key questions in the preclinical and clinical evaluation of new targeted drugs. Examples include imaging of the expression and inhibition of drug targets, noninvasive tissue pharmacokinetics, and early assessment of the tumor response.

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Positron emission tomographic assessment of ?metabolic flare" to predict response of metastatic breast cancer to antiestrogen therapy

Cited by 260 publications

References 8 publications

PET/CT Imaging for Monitoring Recurrence and Evaluating Response to Treatment in Breast Cancer

PET/CT Imaging for Monitoring Recurrence and Evaluating Response to Treatment in Breast Cancer

Role of Positron Emission Tomography for the Monitoring of Response to Therapy in Breast Cancer

Technology Insight: novel imaging of molecular targets is an emerging area crucial to the development of targeted drugs

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