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Whole-Body HER2 Heterogeneity Identified on HER2 PET in HER2-Negative, -Low, and -Positive Metastatic Breast Cancer.
Eisses, Bertha; van Geel, Jasper J L; Brouwers, Adrienne H; Bensch, Frederike; Elias, Sjoerd G; Kuip, Evelien J M; Jager, Agnes; van der Vegt, Bert; Lub-de Hooge, Marjolijn N; Emmering, Jasper; Arens, Anne I J; Zwezerijnen, Gerben J C; Vugts, Daniëlle J; Menke-van der Houven van Oordt, C Willemien; de Vries, Elisabeth G E; Schröder, Carolina P.
Afiliación
  • Eisses B; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • van Geel JJL; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Brouwers AH; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherland.
  • Bensch F; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Elias SG; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
  • Kuip EJM; Department of Medical Oncology, Radboud Medical Center, Nijmegen, The Netherlands.
  • Jager A; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
  • van der Vegt B; Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Lub-de Hooge MN; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherland.
  • Emmering J; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
  • Arens AIJ; Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • Zwezerijnen GJC; Department of Radiology and Nuclear Medicine, Radboud Medical Center, Nijmegen, The Netherlands.
  • Vugts DJ; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.
  • Menke-van der Houven van Oordt CW; Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.
  • de Vries EGE; Department of Medical Oncology and Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; and.
  • Schröder CP; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Nucl Med ; 65(10): 1540-1547, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-39237347
ABSTRACT
Understanding which patients with human epidermal growth factor receptor 2 (HER2)-negative or -low metastatic breast cancer (MBC) benefit from HER2-targeted strategies is urgently needed. We assessed the whole-body heterogeneity of HER2 expression on 89Zr-trastuzumab PET (HER2 PET) and the diagnostic performance of HER2 PET in a large series of patients, including HER2-negative and -low MBC.

Methods:

In the IMPACT-MBC study, patients with newly diagnosed and nonrapidly progressive MBC of all subtypes were included. Metastasis HER2 status was determined by immunohistochemistry and in situ hybridization.89Zr-trastuzumab uptake was quantified as SUVmax and SUVmean HER2 immunohistochemistry was related to the quantitative 89Zr-trastuzumab uptake of all metastases and corresponding biopsied metastasis, uptake heterogeneity, and qualitative scan evaluation. A prediction algorithm for HER2 immunohistochemistry positivity based on uptake was developed.

Results:

In 200 patients, 89Zr-trastuzumab uptake was quantified in 5,163 metastases, including 186 biopsied metastases. With increasing HER2 immunohistochemistry status, uptake was higher (geometric mean SUVmax of 7.0, 7.6, 7.3, and 17.4 for a HER2 immunohistochemistry score of 0, 1, 2, or 3+, respectively; P < 0.001). High uptake exceeding 14.6 (90th percentile) was observed in one third of patients with a HER2-negative or -low metastasis biopsy. The algorithm performed best when lesion site and size were incorporated (area under the curve, 0.86; 95% CI, 0.79-0.93).

Conclusion:

HER2 PET had good diagnostic performance in MBC, showing considerable whole-body HER2 heterogeneity and uptake above background in HER2-negative and -low MBC. This provides novel insights into HER2-negative and -low MBC compared with standard HER2 immunohistochemistry on a single biopsy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Receptor ErbB-2 / Metástasis de la Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: J Nucl Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Receptor ErbB-2 / Metástasis de la Neoplasia Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: J Nucl Med Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos