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For: Hao W, Li Y, Du B, Li X. Heterogeneity of estrogen receptor based on 18F-FES PET imaging in breast cancer patients. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00456-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]

For:	Hao W, Li Y, Du B, Li X. Heterogeneity of estrogen receptor based on 18F-FES PET imaging in breast cancer patients. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00456-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]

Number

Cited by Other Article(s)

You S, Xie Y, Ji M, Liu C, Zhao Y, Gong C, Hu S, Li Y, Yang Z, Wang B. ER status conversion and subsequent treatment: an assessment of negative ER expression detected by 18F-FES PET in metastatic breast cancer patients with ER-positive primary tumors. Ther Adv Med Oncol 2023;15:17588359231216093. [PMID: 38107829 PMCID: PMC10725097 DOI: 10.1177/17588359231216093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/30/2023] [Indexed: 12/19/2023] Open

Abstract

Background

The 18F-fluoroestradiol positron emission tomography/computed tomography (18F-FES PET/CT) technique provides a convenient method to evaluate the overall estrogen receptor (ER) expression in metastatic breast cancer (MBC) patients. There are long debates on the characteristics and treatment strategy of patients with positive primary ER lesions but negative ER expression in metastatic disease. 18F-FES PET offers an opportunity to answer this question.

Objectives

This study aimed to characterize the primary ER-positive patients with advanced-stage FES negativity and investigate the real-world treatment decisions made by physicians subsequently, and compare the efficacy between different regimens.

Design

This observational cohort study was conducted at Fudan University Shanghai Cancer Center, enrolling breast cancer patients with ER-positive primary tumors who showed advanced-stage FES negativity.

Methods

Descriptive statistics were used in clinicopathologic characteristics and compared with a chi-square test or t-test. In addition, progression-free survival (PFS) was estimated by the Kaplan-Meier method and compared by log-rank test.

Results

16.6% (52/314) of patients with an ER-positive primary tumor had negative ER expression assessed by 18F-FES for MBC prior to receiving first-line systemic therapy, among whom adjuvant endocrine therapy was prevalently utilized (86.5%, 45/52). The rate of FES negativity in the advanced stage was negatively correlated with levels of ER expression of primary tumors. Chemotherapy (83.3%, 40/48) was the most common treatment strategy afterward, among which capecitabine monotherapy (62.5%, 25/40) was a dominant alternative. PFS was significantly prolonged with capecitabine alone versus other chemotherapy (median PFS: 13.14 versus 6.21 months, p = 0.029).

Conclusion

Negative conversion of ER in MBC detected by 18F-FES occurred frequently. Patients with lower ER expression in the primary lesion were more likely to have negative ER expression in the metastasis. In real-world clinical practice, most physicians primarily opted for chemotherapy, with capecitabine monotherapy being a commonly selected regimen.

Trial registration

ClinicalTrials.gov identifier: NCT05797987.

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Affiliation(s)

Shuhui You Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Yizhao Xie Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai, China
Mengjing Ji Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China Center for Biomedical Imaging, Fudan University, Shanghai, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
Cheng Liu Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China Center for Biomedical Imaging, Fudan University, Shanghai, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
Yannan Zhao Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Chengcheng Gong Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Shihui Hu Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Yumeng Li Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
Zhongyi Yang Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No. 270, Dongan Road, Shanghai 200032, China Center for Biomedical Imaging, Fudan University, Shanghai, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, China
Biyun Wang Department of Breast and Urological Medical Oncology, Fudan University Shanghai Cancer Center, 130 Dongan Road, Xuhui District, Shanghai 200032, China Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

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Xie Y, Du X, Zhao Y, Gong C, Hu S, You S, Song S, Hu X, Yang Z, Wang B. Chemotherapy Shows a Better Efficacy Than Endocrine Therapy in Metastatic Breast Cancer Patients with a Heterogeneous Estrogen Receptor Expression Assessed by ¹⁸F-FES PET. Cancers (Basel) 2022;14:cancers14143531. [PMID: 35884590 PMCID: PMC9323202 DOI: 10.3390/cancers14143531] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 12/04/2022] Open

Affiliation(s)

Yizhao Xie Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Xinyue Du Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.) Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China Center for Biomedical Imaging, Fudan University, Shanghai 200032, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China
Yannan Zhao Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Chengcheng Gong Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Shihui Hu Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Shuhui You Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Shaoli Song Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.) Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China Center for Biomedical Imaging, Fudan University, Shanghai 200032, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China
Xichun Hu Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.)
Zhongyi Yang Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.) Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China Center for Biomedical Imaging, Fudan University, Shanghai 200032, China Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai 200032, China Correspondence: (Z.Y.); (B.W.); Tel.: +86-21-64175590-86908 (B.W.); Fax: +86-21-54520250 (B.W.)
Biyun Wang Department of Breast Cancer and Urological Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China; (Y.X.); (Y.Z.); (C.G.); (S.H.); (S.Y.); (X.H.) Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; (X.D.); (S.S.) Correspondence: (Z.Y.); (B.W.); Tel.: +86-21-64175590-86908 (B.W.); Fax: +86-21-54520250 (B.W.)

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