The predictive role of metabolic tumor volume on no response to neoadjuvant chemotherapy in patients with breast cancer

J Oncol Pharm Pract. 2020 Sep;26(6):1415-1420. doi: 10.1177/1078155219898504. Epub 2020 Jan 19.

Abstract

Introduction: To evaluate the predictive significance of pretreatment metabolic tumor volume on pathologic response in patients who received neoadjuvant chemotherapy for breast cancer.

Methods: Seventy patients who received neoadjuvant chemotherapy between 2013 and 2017 years were enrolled in the study. Pathologic responses and 18-fluorodeoxyglucose positron emission tomography/computed tomography metabolic dates of patients were obtained from archive files.

Results: Forty-six (65.7%) patients were in stage II and 24 (34.3%) patients were in stage III; 25 (35.7%) patients were human epidermal growth factor receptor 2 positive, 46 (65.7%) patients were estrogen receptor-positive, 26 (37.1%) patients were progesterone receptor-positive. According to the Miller-Payne grading system, 24 (34.3%) patients constituted 100% pathological response; patients with 91-99% pathological response were 12 (17.1%), the number of patients with non-pathologic response was 6 (8.6%). Median metabolic tumor volume was 7.3 cm3 (7.1 ± 3.5), 8.8 (11.4 ± 9.4), 7.7 (8.3 ± 4.6) and 22 cm3 (19.8 ± 11.0) in patients with stages IIA, IIB, IIIA, and IIIB, respectively (p = 0.032). In Miller-Payne grading, the median metabolic tumor volume value was higher in patients with no pathologic response group than 100% response group (p = 0.003). The cut-off metabolic tumor volume value determining no pathologic response was calculated as higher than 13.62 cm3 (sensitivity 83.3% and specificity 82.8%).

Conclusions: Our study results suggest that higher pretreatment metabolic tumor volume values are predictive on no pathologic response in patients treated with neoadjuvant chemotherapy for breast cancer.

Keywords: Breast cancer; metabolic tumor volume; neoadjuvant chemotherapy; pathologic response.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / drug therapy*
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Tumor Burden

Substances

  • Fluorodeoxyglucose F18