(89)Zr-trastuzumab PET/CT for detection of human epidermal growth factor receptor 2-positive metastases in patients with human epidermal growth factor receptor 2-negative primary breast cancer Journal Article

   

Authors:	Ulaner, G. A.; Hyman, D. M.; Lyashchenko, S. K.; Lewis, J. S.; Carrasquillo, J. A.
Article Title:	(89)Zr-trastuzumab PET/CT for detection of human epidermal growth factor receptor 2-positive metastases in patients with human epidermal growth factor receptor 2-negative primary breast cancer
Abstract:	Purpose The aim of this study was to determine if imaging with Zr-89-trastuzumab, a human epidermal growth factor receptor 2 (HER2)-targeting PET tracer, can detect HER2-positive metastases in patients with HER2-negative primary breast cancer. Methods As part of an institutional review board-approved, prospective clinical trial of Zr-89-trastuzumab PET/CT (ClinicalTrials.gov identifier NCT02286843), a second group of 11 patients with HER2-negative primary breast cancer and known metastatic disease were recruited. Patients with confirmed HER2-negative primary breast cancer underwent Zr-89-trastuzumab PET/CT to screen for Zr-89-trastuzumab-avid lesions suggestive of unsuspected HER2-positive metastases. Zr-89-trastuzumab-avid lesions on PET/CT were biopsied and pathologically examined to determine HER2 status. Results All 11 patients had confirmed HER2-negative primary breast cancer. Four patients demonstrated suspicious foci on Zr-89-trastuzumab PET/CT. Of these 4 patients, 1 patient had biopsy-proven HER2-positive metastases. The other 3 patients with suspicious Zr-89-trastuzumab-avid foci had biopsy demonstrating a metastasis that was HER2-negative and were considered false-positive Zr-89-trastuzumab PET foci. Combined with a published report of the first 9 patients, there have been a total of 20 HER2-negative primary breast cancer patients, with 3 patients (15%) having pathologically confirmed HER2-positive distant metastases and 6 (30%) with suspicious Zr-89-trastuzumab-avid foci that were HER2-negative on pathology, which were thus considered false-positive Zr-89-trastuzumab findings. Conclusions This second group of patients confirms the proof of concept that Zr-89-trastuzumab PET/CT detects unsuspected HER2-positive metastases in a subset of patients with HER2-negtive primary breast cancer. False-positive Zr-89-trastuzumab-avid foci present a challenge to using this tracer.
Keywords:	chemotherapy; breast cancer; tumors; antibodies; trastuzumab; pet; ct; her2; impact; plus
Journal Title:	Clinical Nuclear Medicine
Volume:	42
Issue:	12
ISSN:	0363-9762
Publisher:	Lippincott Williams & Wilkins
Date Published:	2017-12-01
Start Page:	912
End Page:	917
Language:	English
ACCESSION:	WOS:000415755700015
DOI:	10.1097/rlu.0000000000001820
PROVIDER:	wos
PMCID:	PMC5708879
PUBMED:	28872549
Notes:	Article -- Source: Wos

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