Tumour response interpretation with new tumour response criteria vs the World Health Organisation criteria in patients with bone-only metastatic breast cancer

• Published in: British journal of cancer 2010-02, Vol.102 (4), p.651-657
• Main Authors: Hamaoka, T, Costelloe, C M, Madewell, J E, Liu, P, Berry, D A, Islam, R, Theriault, R L, Hortobagyi, G N, Ueno, N T
• Format: Article
• Language: English
• Subjects: 631/67/322/803; 692/699/67/1347; 692/700/1421; 692/700/1750; Adult; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - mortality; Bone Neoplasms - secondary; Bone Neoplasms - therapy; Breast Neoplasms - diagnostic imaging; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer Research; Carcinoma - diagnostic imaging; Carcinoma - pathology; Carcinoma - secondary; Clinical Study; Disease-Free Survival; Drug Resistance; Epidemiology; Female; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm Staging - methods; Oncology; Retrospective Studies; Survival Analysis; Tomography, X-Ray Computed; Treatment Outcome; Tumors; World Health Organization
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6605546

Background: We compared the utility of a new response classification (MDA; based on computed tomography (CT), magnetic resonance imaging (MRI), plain radiography (XR), and skeletal scintigraphy (SS)) and the World Health Organisation response classification (WHO; based on XR and SS) in stratifying breast cancer patients with bone-only metastases with respect to progression-free survival (PFS), overall survival (OS), and clinical response. Methods: We retrospectively reviewed 41 patients with bone-only metastatic breast cancer and assigned responses according to the MDA and WHO criteria. We analysed whether the MDA or WHO response classifications correlated with PFS and OS. Results: With the MDA criteria, there were significant differences in PFS between patients classified as responders and those classified as nonresponders ( P =0.025), but with the WHO criteria, there were not. Neither criteria distinguished responders from nonresponders in terms of OS. MDA response criteria correlated better than WHO response criteria with clinical response assessment. Conclusions: The MDA classification is superior to the WHO classification in differentiating between responders and nonresponders among breast cancer patients with bone-only metastases. Application of the MDA classification may allow bone lesions to be considered measurable disease. Prospective study is needed to test the MDA classification among patients with bone metastasis.