Intracellular hypoxia measured by 18F-fluoromisonidazole positron emission tomography has prognostic impact in patients with estrogen receptor-positive breast cancer

Background Hypoxia is a key driver of cancer progression. We evaluated the prognostic impact of .sup.18F-fluoromisonidazole (FMISO) prior to treatment in patients with breast cancer. Methods Forty-four patients with stage II/III primary breast cancer underwent positron emission tomography/computed w...

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Published in:Breast cancer research : BCR 2018-07, Vol.20 (1), p.78-78, Article 78
Main Authors: Asano, Aya, Ueda, Shigeto, Kuji, Ichiei, Yamane, Tomohiko, Takeuchi, Hideki, Hirokawa, Eiko, Sugitani, Ikuko, Shimada, Hiroko, Hasebe, Takahiro, Osaki, Akihiko, Saeki, Toshiaki
Format: Article
Language:English
Subjects:
18F-fluoromisonidazole
Angiogenesis
Breast cancer
Cancer therapies
Care and treatment
Chemotherapy
Clinical trials
Development and progression
Enzymes
Estrogen receptors
Growth factors
Head & neck cancer
Hypoxia
Interleukin 8
Lung cancer
Medical imaging
Medical prognosis
Multivariate analysis
Nitroimidazoles
NMR
Nuclear magnetic resonance
Oncology
Patients
Plasma levels
Positron emission tomography
Progesterone
Prognosis
Radiation therapy
Surgery
Survival
Tomography
Transforming growth factor
Tumors
Vascular endothelial growth factor
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Summary:Background Hypoxia is a key driver of cancer progression. We evaluated the prognostic impact of .sup.18F-fluoromisonidazole (FMISO) prior to treatment in patients with breast cancer. Methods Forty-four patients with stage II/III primary breast cancer underwent positron emission tomography/computed with .sup.18F-fluorodeoxyglucose (FDG-PET/CT) and FMISO. After measurement by FDG-PET/CT, the tissue-to-blood ratio (TBR) was obtained using FMISO-PET/CT. FMISO-TBR was compared for correlation with clinicopathological factors, disease-free survival (DFS), and overall survival (OS). Multiplex cytokines were analyzed for the correlation of FMISO-TBR. Results Tumors with higher nuclear grade and negativities of estrogen receptor (ER) and progesterone receptor had significantly higher FMISO-TBR than other tumors. Kaplan-Meier survival curves showed that patients with a higher FMISO-TBR (cutoff, 1.48) had a poorer prognosis of DFS (p = 0.0007) and OS (p = 0.04) than those with a lower FMISO-TBR. Multivariate analysis indicated that higher FMISO-TBR and ER negativity were independent predictors of shorter DFS (p = 0.01 and 0.03). Higher FMISO-TBR was associated with higher plasma levels of angiogenic hypoxic markers such as vascular endothelial growth factor, transforming growth factor-[alpha], and interleukin 8. Conclusions FMISO-PET/CT is useful for assessing the prognosis of patients with breast cancer, but it should be stratified by ER status. Trial registration UMIN Clinical Trials Registry, UMIN000006802. Registered on 1 December 2011. Keywords: Breast cancer, Hypoxia, Prognosis, .sup.18F-fluoromisonidazole, Positron emission tomography
ISSN:1465-542X
1465-5411
1465-542X
DOI:10.1186/s13058-018-0970-6