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Measuring residual estrogen receptor availability during fulvestrant therapy in patients with metastatic breast cancer.
- Source :
-
Cancer discovery [Cancer Discov] 2015 Jan; Vol. 5 (1), pp. 72-81. Date of Electronic Publication: 2014 Nov 07. - Publication Year :
- 2015
-
Abstract
- Unlabelled: It is unknown whether the current dose of fulvestrant, an estrogen receptor (ER) antagonist, is sufficient for maximal ER downregulation in patients with metastatic breast cancer. We performed a feasibility study to assess ER availability before and during fulvestrant. Sixteen patients with ER-positive metastatic breast cancer underwent positron emission tomography/computed tomography (PET/CT) at baseline (scan 1), day 28 (scan 2), and day 84 (scan 3) to monitor tumor [(18)F]fluoroestradiol (FES) uptake. Incomplete reduction in ER availability was predefined as <75% decrease in median tumor FES uptake and a residual standardized uptake value (SUVmax) of ≥1.5. In total, 131 FES-positive lesions were identified (median SUVmax of 2.9; range, 1.7-6.5). The median change in patients during fulvestrant treatment was -85% at scan 2, but varied widely (-99% to +60%). Fulvestrant reduced tumor FES uptake incompletely at scan 2 in 6 (38%) of the 16 patients, which was associated with early progression.<br />Significance: Serial imaging of tumor estrogen uptake by FES-PET can give insight into the dose needed for ER antagonists to completely abolish ER. FES-PET showed significant residual ER availability in tumors during fulvestrant therapy in 38% of patients, which was associated with early progression.<br /> (©2014 American Association for Cancer Research.)
- Subjects :
- Aged
Antineoplastic Agents, Hormonal administration & dosage
Antineoplastic Agents, Hormonal pharmacokinetics
Breast Neoplasms pathology
Disease Progression
Estradiol administration & dosage
Estradiol pharmacokinetics
Estradiol therapeutic use
Female
Fulvestrant
Humans
Middle Aged
Neoplasm Metastasis
Tamoxifen administration & dosage
Tamoxifen therapeutic use
Treatment Outcome
Antineoplastic Agents, Hormonal therapeutic use
Breast Neoplasms diagnosis
Breast Neoplasms drug therapy
Estradiol analogs & derivatives
Positron-Emission Tomography
Receptors, Estrogen antagonists & inhibitors
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 2159-8290
- Volume :
- 5
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cancer discovery
- Publication Type :
- Academic Journal
- Accession number :
- 25380844
- Full Text :
- https://doi.org/10.1158/2159-8290.CD-14-0697