Potentially 'powerful tool' for noninvasive cancer treatment assessment

Linden and colleagues find PET scans can provide accurate, early assessment of response to breast-cancer therapy
Dr. Hannah Linden
Dr. Hannah Linden and colleagues discovered the response of patient's with estrogen receptor positive breast cancer to standard aromatase-inhibitor therapy can be measured by noninvasive imaging with similar results to invasive needle sampling.

Noninvasive imaging can measure how well patients with the most common form of breast cancer—estrogen receptor positive type—respond to standard aromatase inhibitor therapy after only two weeks and shows findings similar to those identified by more invasive needle sampling. The research will comprise a poster presentation for the American Society of Clinical Oncology's annual meeting May 29-June 2 in Orlando, Fla.

Using Positron Emission Tomography (PET) scanning and a glucose analogue called FDG, a research team led by Dr. Hannah Linden, of the Seattle Cancer Care Alliance, and Dr. David Mankoff, of the University of Washington, scanned 21 patients before and after two weeks of aromatase inhibitor therapy. Many of the patients also underwent a needle biopsy as a control measure to compare the two techniques.

The results—16 of the 21 patients had a greater than 20 percent decline in FDG values—“paralleled perfectly” earlier work done by UK-based researchers who used needle biopsies to measure whether the proliferation of cancer cells was slowed by therapy, according to Linden, who is a breast-cancer oncologist.
“Our findings are exciting because they suggest that we can measure a patient’s response to therapy noninvasively, and PET scanning provides us simultaneous quantitative metabolic measurements at multiple tumor sites,” Linden said. “PET has the potential to be a powerful tool to help doctors make important treatment decisions in as little as two weeks instead of two or more months.”
It’s common for patients with estrogen receptor-positive cancer to a bone-dominant type, yet they have remained largely unstudied in clinical trials because they are very difficult to image, Linden said. “Our work allowed us to study a common problem in a way that’s not been done before and to help more people,” she said.

“More work needs to be done, but in my mind this was a home run,” Linden said.

Grants from “Progress for Patients,” the National Cancer Institute and the Avon Foundation provided funding for the study.

Joining Linden and Markoff were researchers from the Hutchinson Center, University of Washington and the University of Arizona Cancer Center.

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