Abstract
Purpose: Since we have previously shown that the efflux rate of technetium 99m (99mTc) sestamibi, a transport substrate of P-glycoprotein (Pgp), is directly correlated with Pgp levels in untreated breast carcinoma, we tested whether tumor clearance of 99mTc-sestamibi may be predictive of therapeutic response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Patients and Methods: Thirty-nine patients with stage III disease, median tumor diameter 5.8 cm (range, 3 to 10) were enrolled onto this prospective clinical trial and underwent 99mTc-sestamibi scan before neoadjuvant chemotherapy. Patients were injected intravenously (IV) with 740 MBq of 99mTc-sestamibi; a 15-minute dynamic study was performed, and static planar images were obtained at 0.5, 1, 2, and 4 hours. The time to half clearance of 99mTc-sestamibi was calculated in each patient from decay corrected time-activity curves using a monoexponential fitting. Patients were treated with epirubicin 150 mg/m2 IV every 2 weeks for three courses and then underwent surgery within 3 weeks from the completion of chemotherapy. Residual tumor was assessed by pathologic examination of mastectomy specimens. Results: Seventeen of 39 patients showed a rapid tumor clearance of 99mTc-sestamibi (time to half clearance [t( 1/4 )] ≤ 204 minutes) and 15 of these 17 (88%) showed a highly cellular macroscopic residual tumor at histology that indicated lack of tumor response to neoadjuvant chemotherapy. In contrast, only eight of 22 (36%) with prolonged retention of 99mTc-sestamibi (t( 1/4 ) > 204 minutes) showed residual macroscopic tumor at histology (Fisher's exact test, P <.01). Conclusion: A rapid tumor clearance of 99mTc-sestamibi may predict lack of tumor response to neoadjuvant chemotherapy with drugs affected by the multidrug- resistant phenotype in patients with locally advanced breast carcinoma.
| Original language | English |
|---|---|
| Pages (from-to) | 1677-1683 |
| Number of pages | 7 |
| Journal | Journal of Clinical Oncology |
| Volume | 16 |
| Issue number | 5 |
| Publication status | Published - May 1998 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
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Tumor clearance of technetium 99m-sestamibi as a predictor of response to neoadjuvant chemotherapy for locally advanced breast cancer. / Ciarmiello, A.; Del Vecchio, S.; Silvestro, P.; Potena, M. I.; Carriera, M. V.; Thomas, R.; Botti, G.; D'Aiuto, G.; Salvatore, M.
In: Journal of Clinical Oncology, Vol. 16, No. 5, 05.1998, p. 1677-1683.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tumor clearance of technetium 99m-sestamibi as a predictor of response to neoadjuvant chemotherapy for locally advanced breast cancer
AU - Ciarmiello, A.
AU - Del Vecchio, S.
AU - Silvestro, P.
AU - Potena, M. I.
AU - Carriera, M. V.
AU - Thomas, R.
AU - Botti, G.
AU - D'Aiuto, G.
AU - Salvatore, M.
PY - 1998/5
Y1 - 1998/5
N2 - Purpose: Since we have previously shown that the efflux rate of technetium 99m (99mTc) sestamibi, a transport substrate of P-glycoprotein (Pgp), is directly correlated with Pgp levels in untreated breast carcinoma, we tested whether tumor clearance of 99mTc-sestamibi may be predictive of therapeutic response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Patients and Methods: Thirty-nine patients with stage III disease, median tumor diameter 5.8 cm (range, 3 to 10) were enrolled onto this prospective clinical trial and underwent 99mTc-sestamibi scan before neoadjuvant chemotherapy. Patients were injected intravenously (IV) with 740 MBq of 99mTc-sestamibi; a 15-minute dynamic study was performed, and static planar images were obtained at 0.5, 1, 2, and 4 hours. The time to half clearance of 99mTc-sestamibi was calculated in each patient from decay corrected time-activity curves using a monoexponential fitting. Patients were treated with epirubicin 150 mg/m2 IV every 2 weeks for three courses and then underwent surgery within 3 weeks from the completion of chemotherapy. Residual tumor was assessed by pathologic examination of mastectomy specimens. Results: Seventeen of 39 patients showed a rapid tumor clearance of 99mTc-sestamibi (time to half clearance [t( 1/4 )] ≤ 204 minutes) and 15 of these 17 (88%) showed a highly cellular macroscopic residual tumor at histology that indicated lack of tumor response to neoadjuvant chemotherapy. In contrast, only eight of 22 (36%) with prolonged retention of 99mTc-sestamibi (t( 1/4 ) > 204 minutes) showed residual macroscopic tumor at histology (Fisher's exact test, P <.01). Conclusion: A rapid tumor clearance of 99mTc-sestamibi may predict lack of tumor response to neoadjuvant chemotherapy with drugs affected by the multidrug- resistant phenotype in patients with locally advanced breast carcinoma.
AB - Purpose: Since we have previously shown that the efflux rate of technetium 99m (99mTc) sestamibi, a transport substrate of P-glycoprotein (Pgp), is directly correlated with Pgp levels in untreated breast carcinoma, we tested whether tumor clearance of 99mTc-sestamibi may be predictive of therapeutic response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Patients and Methods: Thirty-nine patients with stage III disease, median tumor diameter 5.8 cm (range, 3 to 10) were enrolled onto this prospective clinical trial and underwent 99mTc-sestamibi scan before neoadjuvant chemotherapy. Patients were injected intravenously (IV) with 740 MBq of 99mTc-sestamibi; a 15-minute dynamic study was performed, and static planar images were obtained at 0.5, 1, 2, and 4 hours. The time to half clearance of 99mTc-sestamibi was calculated in each patient from decay corrected time-activity curves using a monoexponential fitting. Patients were treated with epirubicin 150 mg/m2 IV every 2 weeks for three courses and then underwent surgery within 3 weeks from the completion of chemotherapy. Residual tumor was assessed by pathologic examination of mastectomy specimens. Results: Seventeen of 39 patients showed a rapid tumor clearance of 99mTc-sestamibi (time to half clearance [t( 1/4 )] ≤ 204 minutes) and 15 of these 17 (88%) showed a highly cellular macroscopic residual tumor at histology that indicated lack of tumor response to neoadjuvant chemotherapy. In contrast, only eight of 22 (36%) with prolonged retention of 99mTc-sestamibi (t( 1/4 ) > 204 minutes) showed residual macroscopic tumor at histology (Fisher's exact test, P <.01). Conclusion: A rapid tumor clearance of 99mTc-sestamibi may predict lack of tumor response to neoadjuvant chemotherapy with drugs affected by the multidrug- resistant phenotype in patients with locally advanced breast carcinoma.
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M3 - Article
VL - 16
SP - 1677
EP - 1683
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 5
ER -