The roles of 68Ga-PSMA PET/CT and 18F-FDG PET/CT imaging in patients with triple-negative breast cancer and the association of tissue PSMA and claudin 1, 4, and 7 levels with PET findings

Arslan, Esra; Ergül, Nurhan; Beyhan, Ediz; Fenercioğlu, Özge Erol; Sahin, Rahime; Cin, Merve; Havare, Semiha Battal; Trabulus, Fadime Didem Can; Mermut, Özlem; Akbas, Sinem; Çermik, Tevfik Fikret

doi:10.1097/mnm.0000000000001663

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…Few studies have reported the results of PET/CT with radiolabeled PSMA ligands in breast cancer patients [12,[16][17][18][19], most of which were single-case presentations. Two larger studies are of special interest.…”

Section: Discussionmentioning

confidence: 99%

“…The study revealed PSMA positivity in 76% of primary breast cancer tumors and 90% of metastatic lesions in all breast cancer subtypes, although PSMA scans exhibited a lower detection rate than [ 18 F]FDG in the analyzed group. Arslan et al presented a comparison between PSMA immunohistochemical expression and PSMA radiotracer uptake in breast cancer, which indicated a positive and similar level [17]. Bertagna et al presented a systematic review, which included 11 case studies evaluating radiolabeled PSMA PET/CT in breast cancer; all of them were 68 Ga-PSMA imaging [18].…”

Section: Discussionmentioning

confidence: 99%

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Head-to-Head Comparison of [18F]PSMA-1007 and [18F]FDG PET/CT in Patients with Triple-Negative Breast Cancer

Andryszak,

Świniuch,

Wójcik

et al. 2024

Cancers

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Background: Triple-negative breast cancer (TNBC) exhibits high aggressiveness and a notably poorer prognosis at advanced stages. Nuclear medicine offers new possibilities, not only for diagnosis but also potentially promising therapeutic strategies. This prospective study explores the potential of prostate-specific membrane antigen (PSMA) as a diagnostic and therapeutic target in TNBC. Methods: the research investigates PSMA expression in vivo among TNBC patients using [18F]PSMA-1007 PET/CT and compares it head-to-head with the standard-of-care [18F]FDG PET/CT. Results: The study involves 10 TNBC patients, revealing comparable uptake of [18F]PSMA-1007 and [18F]FDG in primary and metastatic lesions. Nodal metastases were found in eight patients, showing similar SUVmax values in both modalities. Two patients had uncountable lung metastases positive in both [18F]FDG and [18F]PSMA-1007 scans. PET-positive bone metastases were identified by 18F-PSMA in four patients, while elevated [18F]FDG uptake was found only in three of them. Distant metastases displayed higher SUVmax values in the [18F]PSMA-1007 PET/CT, as compared to [18F]FDG. Additionally, brain metastases were exclusively detected using [18F]PSMA-1007. Conclusions: the findings provide valuable insights into the expression of PSMA in TNBC and underscore the potential clinical significance of [18F]PSMA-1007 PET/CT in enhancing both diagnostic and therapeutic approaches for this aggressive breast cancer subtype.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Head-to-Head Comparison of [18F]PSMA-1007 and [18F]FDG PET/CT in Patients with Triple-Negative Breast Cancer

Andryszak,

Świniuch,

Wójcik

et al. 2024

Cancers

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“…The overall sensitivity and specificity were, respectively, 99.2% and 93.6% for [ 18 F]FDG vs. 84% and 91.8% for [ 68 Ga]Ga-PSMA-11, respectively, with similar accuracy ([ 18 F]FDG AUC 0.86-0.95; [ 68 Ga]Ga-PSMA-11 AUC 0.74-0.94). Another study by Arslan et al [24] prospectively reported the results of forty-two TPN BC who underwent both [ 68 Ga]Ga-PSMA-11 and [ 18 F]FDG (thirty-six staging and six recurrent patients). A total of 46 of the 47 primary lesions were FDG avid (mean SUV max 22.2 ± 15.2), whereas 38 of 47 showed PSMA expression (mean SUV max 6.6 ± 3.4).…”

Section: Breast Cancermentioning

confidence: 99%

“…In this context, the possible application of PSMA in the detection of brain metastases should also be considered [23,28,31]. Further data are needed to assess the potential role of PSMA PET in BC patients, which may provide a novel therapeutic vascular target in patients with negative receptor status [23][24][25]. Unclear applications of PSMA-PET include TC, where it may be useful in selected patients with either [ 131 I]I-negative or [ 18 F]FDG-negative tumor lesions [26,28].…”

Section: Perspectives and Conclusionmentioning

confidence: 99%

Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals

Miceli,

Liberini,

Pepe

et al. 2024

Diagnostics

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Background: Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein overexpressed on the surface of tumor cells in most of the patients affected by prostate adenocarcinoma (PCa). However, PSMA expression has also been demonstrated in the endothelial cells of newly formed vessels of various solid tumors, suggesting a role for PSMA in neoangiogenesis. In this scenario, gallium-68 (68Ga) or fluoro-18 (18F)-labeled PSMA positron emission tomography (PET) may play a role in tumors other than PCa, generally evaluated employing other radiopharmaceuticals targeting different pathways. This review aims to investigate the detection rate of PSMA-PET compared to other radiopharmaceuticals (especially [18F]FDG) in non-prostate tumors to identify patients who may benefit from the use of such a theragnostic agent. Methods: We performed a bibliographic search on three different databases until February 2024 using the following terms: “positron emission tomography”, “PET”, “PET/CT”, “Prostate-specific membrane antigen”, “PSMA”, “non-prostate”, “not prostate cancer”, “solid tumor”, “FDG”, “Fluorodeoxyglucose”, “FAPi”, “FET”, “MET”, “DOPA”, “choline”, “FCH”, “FES”, “DOTATOC”, “DOTANOC”, and “DOTATATE”. Only original articles edited in English with at least 10 patients were included. Results: Out of a total of 120 articles, only 25 original articles comparing PSMA with other radiotracers were included in this study. The main evidence was demonstrated in renal cell carcinoma, where PSMA showed a higher detection rate compared to [18F]FDG PET/CT, with implications for patient management. PSMA PET may also improve the assessment of other entities, such as gliomas, in defining regions of early neoangiogenesis. Further data are needed to evaluate the potential role of PSMA-PET in triple-negative breast cancer as a novel therapeutic vascular target. Finally, unclear applications of PSMA-PET include thyroid and gastrointestinal tumors. Conclusions: The present review shows the potential use of PSMA-labeled PET/CT in solid tumors beyond PCa, underlining its value over other radiopharmaceuticals (mainly [18F]FDG). Prospective clinical trials with larger sample sizes are crucial to further investigate these possible clinical applications.

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The impact of PET imaging on triple negative breast cancer: an updated evidence-based perspective

Filippi,

Urso,

Ferrari

et al. 2024

Eur J Nucl Med Mol Imaging

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Introduction Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by the absence of estrogen, progesterone, and HER2 receptors. It predominantly affects younger women and is associated with a poor prognosis. This systematic review aims to evaluate the current role of positron emission tomography (PET) in the management of TNBC patients and to identify future research directions. Methods We systematically searched the PubMed, Scopus, and Web of Science databases up to February 2024. A team of five researchers conducted data extraction and analysis. The quality of the selected studies was assessed using a specific evaluation form. Results Twenty-eight studies involving 2870 TNBC patients were included in the review. Key clinical applications of PET in TNBC included predicting pathological complete response (pCR) in patients undergoing neoadjuvant chemotherapy (NAC), assessing the prognostic value of baseline PET, and initial disease staging. Two studies utilized PSMA-ligand agents, while the majority used [18F]FDG-based PET. Significant associations were found between baseline [18F]FDG uptake and molecular biomarkers such as PDL-1, androgen receptor, and Ki67. Baseline [18F]FDG PET led to the upstaging of patients from stage IIB to stage IV, influencing treatment decisions and survival outcomes. In the NAC setting, serial PET scans measuring changes in [18F]FDG uptake, indicated by maximum standardized uptake value (SUVmax), predicted pCR with varying cut-off values correlated with different response rates. Semiquantitative parameters such as metabolic tumor volume (MTV) and PET lung index were prognostic for metastatic disease. Conclusions In TNBC patients, [18F]FDG PET is essential for initial disease staging in both localized and metastatic settings. It is also useful for assessing treatment response to NAC. The ability of PET to correlate metabolic activity with molecular markers and predict treatment outcomes highlights its potential in TNBC management. Further prospective studies are needed to refine these clinical indications and establish its definitive role.

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The roles of 68Ga-PSMA PET/CT and 18F-FDG PET/CT imaging in patients with triple-negative breast cancer and the association of tissue PSMA and claudin 1, 4, and 7 levels with PET findings

Cited by 4 publications

References 20 publications

Head-to-Head Comparison of [18F]PSMA-1007 and [18F]FDG PET/CT in Patients with Triple-Negative Breast Cancer

Head-to-Head Comparison of [18F]PSMA-1007 and [18F]FDG PET/CT in Patients with Triple-Negative Breast Cancer

Prostate-Specific Membrane Antigen Positron Emission Tomography Oncological Applications beyond Prostate Cancer in Comparison to Other Radiopharmaceuticals

The impact of PET imaging on triple negative breast cancer: an updated evidence-based perspective

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