PET/CT may be more accurate than bone 4 bone mets AND may also be able 2 predict

[Lani]

how those patients may do (previously posted abstract about being more accurate, this abstract shows that prognosis and SUV value may be correlated

Standardized uptake value (SUV) by positron emission tomography/computed tomography (PET/CT) as a prognostic variable in metastatic breast cancer (MBC).


Sub-category:
HER2+

Category:
Breast Cancer - HER2/ER

Meeting:
2011 ASCO Annual Meeting

Abstract No:
567

Citation:
J Clin Oncol 29: 2011 (suppl; abstr 567)


Attend this session at the
ASCO Annual Meeting!
Session: Breast Cancer - HER2/ER

Type: General Poster Session

Time: Monday June 6, 1:00 PM to 5:00 PM

Location: McCormick Place Hall A


Author(s): P. G. Morris, M. Fazio, K. L. Jhaveri, C. Serna-Tamayo, A. Eaton, S. Patil, G. Ulaner, J. Howard, S. M. Larson, C. Hudis, M. S. Jochelson, H. L. McArthur; Memorial Sloan-Kettering Cancer Center, New York, NY


Abstract Disclosures


Abstract:

Background: The accurate prediction of outcome from MBC is challenging. PET/CT could be useful as it combines anatomical with functional imaging. This could enable greater individualization of treatment. However, there is substantial SUV variation by site. In this retrospective, single-institution study, we examine baseline SUV on PET/CT as a predictor of outcome from MBC. Methods: Patients (Pts) with ≥1 metastatic lesion on PET/CT performed ≤60 days of diagnosis of MBC from 01/01/2001 to 12/31/2008 were identified through institutional databases. Pts who received chemotherapy < 30 days prior to PET/CT were excluded. Electronic medical record reports were reviewed and maximum SUV (SUV-MAX) by site for lesions in bone, liver, lung, and lymph node (LN) was recorded. In a secondary analysis, PET/CT scans were reviewed and SUV-MAX recalculated. Relationships between SUV-MAX tertiles and OS were assessed using Cox regression by site. Results: We identified 285 pts, median age 57 yrs (range 27-90) who had PET/CT at median of 2.3 yrs (range 0-41) from primary BC (67% ER+ and 21% HER2+). The median time between PET/CT and MBC diagnosis was -9 days (range -58 to 59). At median follow-up of 53 mths, 163 pts have died and median OS is 41 mths (95%CI 34-48). The SUV-MAX by site was; bone (N=159) median 7.0 (range 2.1 - 29.6); liver (N=55) median 8.2 (range 2.9 - 51.2); lung (N=89) median 4.7 (range 1.1 - 24.0); LN (N=180) median 6.9 (range 1.2 - 34.0). On univariate analysis, higher SUV in bone was associated with shorter survival (p<0.001); table. This was maintained in multivariate analyses after adjusting for known prognostic variables (p=0.02). A similar trend for shorter survival for higher SUV was noted in liver (p=0.07). However, no relationship between SUV and OS was noted in lung (p =0.34) and LN (p=0.6). Conclusions: This large retrospective study of pts with chemotherapy-naïve MBC suggests that SUV-MAX in bone strongly correlates with prognosis.


SUV in bone: Univariate analysis for OS.
Variable

N (%) N P value HR
Max SUV Tertiles 159 <.001
1 54 (34%) - (ref)
2 53 (33%) - 1.42
3 52 (33%) - 2.76
ER neg 38 (24%) 159 <.001 2.55
HER2 neg 122 (80%) 152 0.56 0.86
Grade 3 103 (75%) 138 0.03 1.95