18F-fluoroestradiol (18F-FES) PET/CT for guiding first-line treatment in patients with HR + /HER2- metastatic breast cancer: impact on progression free survival.
Background: While CDK4/6 inhibitors combined with endocrine therapy (CDK4/6i+ET) have revolutionized treatment for HR+/HER2- metastatic breast cancer (MBC), inter-lesional estrogen receptor (ER) heterogeneity limits therapeutic efficacy in a subset of patients. Whole-body 18F-fluoroestradiol (18F-FE...
| Publicado en: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 53; no. 1; pp. 374 - 389 |
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| Autores principales: | , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=189634285&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 189634285 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Dec2025 vid: 53 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 189634285 186711001 10.1007/s00259-025-07459-w 189634285 ppf: 374 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: 18F-fluoroestradiol (18F-FES) PET/CT for guiding first-line treatment in patients with HR + /HER2- metastatic breast cancer: impact on progression free survival. aug: au: Xie, Yizhao Chen, Yifan Liu, Cheng Zhao, Yannan Gong, Chengcheng Lin, Shuyi Song, Shaoli Wang, Biyun Yang, Zhongyi affil: https://ror.org/00my25942 Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China sug: ab: Background: While CDK4/6 inhibitors combined with endocrine therapy (CDK4/6i+ET) have revolutionized treatment for HR+/HER2- metastatic breast cancer (MBC), inter-lesional estrogen receptor (ER) heterogeneity limits therapeutic efficacy in a subset of patients. Whole-body 18F-fluoroestradiol (18F-FES) PET/CT enables non-invasive ER quantification across all metastatic sites. However, whether 18F-FES-guided therapy selection improves clinical outcomes in relatively large sample cohorts is not yet well-established. Patients and methods: We screened all 1613 HR+/HER2- metastatic breast cancer (MBC) patients from 2020 to 2024 at Fudan University Shanghai Cancer Center. Patients who received standard first line treatment were enrolled in this retrospective study. Results: A total of 473 patients were included in the study. 156(33.0%) and 317 (67.0%) patients were screened or unscreened by 18F-FES-PET before first-line treatment. 111 patients with all-FES positive metastatic lesions and 17 patients with FES heterogeneity received CDK4/6 inhibitors combined with endocrine therapy. 21 patients with all-FES negative metastatic lesions and 7 patients with FES heterogeneity received chemotherapy (CT). As for the unscreened group, 236 received CDK4/6 inhibitors combined with endocrine therapy and 81 received CT. In CDK4/6 inhibitors combined with endocrine therapy cohort, FES-screened group showed a significantly prolonged progression-free survival (PFS) compared with unscreened group (mPFS 32.4 months versus 17.3 months, Hazard Ratio = 0.49; 95% CI, 0.34 to 0.69; p < 0.0001). And chemotherapy cohort showed superior PFS for screened patients as well (mPFS 11.38 months versus 8.91 months, Hazard Ratio = 0.56; 95% CI, 0.33 to 0.94; p = 0.026). Conclusions: HR + /HER2- MBC patients with FES-guided initial treatment showed significantly better efficacy than those who had not been assessed by 18F-FES-PET/CT. This retrospective study highlights the crucial instructive role of FES assessment in evaluating ER expression in patients prior to administering first-line treatment. In the present study, improved PFS was observed when first-line therapy was guided by 18F-FES-PET in newly diagnosed HR+/HER2- MBC patients. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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