Prospective clinical trial of (18)F-fluciclovine PET/CT for determining the response to neoadjuvant therapy in invasive ductal and invasive lobular breast cancers Journal Article


Authors: Ulaner, G. A.; Goldman, D. A.; Corben, A.; Lyashchenko, S. K.; Gönen, M.; Lewis, J. S.; Dickler, M.
Article Title: Prospective clinical trial of (18)F-fluciclovine PET/CT for determining the response to neoadjuvant therapy in invasive ductal and invasive lobular breast cancers
Abstract: 18F-labeled 1-amino-3-fluorocyclobutane-1-carboxylic acid (18Ffluciclovine) is a leucine analog radiotracer that depicts amino acid transport into cells. 18F-fluciclovine PET/CT visualizes malignancy, including prostate cancer, invasive ductal breast cancer, and invasive lobular breast cancer. Whether changes in 18F-fluciclovine avidity reflect changes in tumor burden resulting from treatment has not been shown. In this prospective clinical trial (clinical trials.gov: NCT01864083), changes in 18F-fluciclovine avidity after neoadjuvant therapy were compared to breast cancer therapy response, as determined by residual tumor burden on pathology, were evaluated. Methods: Twenty-four women with a new diagnosis of locally advanced invasive ductal breast cancer (n 5 18) or invasive lobular breast cancer (n 5 6) underwent 18F-fluciclovine PET/CT before and after the completion of neoadjuvant systemic therapy. SUVmax, SUVmean, metabolic tumor volume, and total lesion avidity were obtained for the primary breast tumor, axillary lymph nodes, and extraaxillary lymph nodes on each examination and corrected for background 18F-fluciclovine avidity. The relationship between changes in 18F-fluciclovine avidity and the percentage of reduction of tumor on pathology was assessed with the Spearman rank correlation. Results: The median decrease in the corrected SUVmax of the primary breast lesions was 99% (range, 33%-100%). The median reduction of tumor on pathology was 92% (range, 10%-100%). Changes in 18F-fluciclovine avidity were strongly correlated with the percentage of reduction of tumor on pathology (Spearman r, 0.79; 95% CI, 0.56-0.90; P , 0.001). Conclusion: Changes in 18F-fluciclovine avidity strongly correlated with the tumor response on pathology in this pilot study.
Keywords: response; pet/ct; 18f-fluciclovine; ductal breast cancer; lobular breast cancer
Journal Title: Journal of Nuclear Medicine
Volume: 58
Issue: 7
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2017-07-01
Start Page: 1037
End Page: 1042
Language: English
DOI: 10.2967/jnumed.116.183335
PROVIDER: scopus
PUBMED: 27856630
PMCID: PMC6944156
DOI/URL:
Notes: Article -- Export Date: 2 August 2017 -- Source: Scopus
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MSK Authors
  1. Gary Ulaner
    146 Ulaner
  2. Mithat Gonen
    1028 Gonen
  3. Maura N Dickler
    262 Dickler
  4. Jason S Lewis
    456 Lewis
  5. Debra Alyssa Goldman
    158 Goldman