Article Figures & Data
Figures
- FIGURE 1.
Diagram of recruitment and diagnostic classification of study subjects, according to the Standards for Reporting Diagnostic Accuracy. BC = breast cancer; ABY = [68Ga]Ga-ABY-025; IHC = immunohistochemistry.
- FIGURE 2.
Color-coded clinical response in patients with breast cancer. x-axis is HER2 status according to immunohistochemistry with ISH from trial biopsies (n = 40). y-axis is corresponding uptake in biopsied lesions using [68Ga]Ga-ABY-025 PET/CT. Red line indicates SUVmax of 6.0. BC = breast cancer.
- FIGURE 3.
[68Ga]Ga-ABY-025 PET/CT and [18F]F-FDG PET/CT images at baseline with [18F]F-FDG PET/CT follow-up after 2 cycles of treatment in biopsy-confirmed HER2-positive disease. (A) Patient with high [68Ga]Ga-ABY-025 uptake (SUVmax, 21), who previously received 3 lines of treatment. [18F]F-FDG PET/CT follow-up showed complete metabolic response. (B) Patient with low uptake (SUVmax, 5.4), who previously received 3 lines of treatment. [18F]F-FDG PET/CT follow-up showed disease progression (Δ-TLG, +68%) despite HER2-targeted treatment. (C) Patient with heterogeneous [68Ga]Ga-ABY-025 uptake, who previously received 7 lines of treatment. [18F]F-FDG PET/CT follow-up showed heterogeneous response, with lesions higher in [68Ga]Ga-ABY-025 uptake tending to have better response. Arrows indicate biopsy sites.
- FIGURE 4.
Receiver operating characteristic curve analysis of positive metabolic response after 2 cycles of HER2-targeted treatment in breast cancer patients according to [68Ga]Ga-ABY-025 uptake. Optimal SUVmax cutoff (red circle and diamonds) was 6.0 (n = 47; P = 0.01) in soft-tissue metastases (green line), 16.2 (n = 28; P = 0.003) in skeletal metastases (blue line), and 10.7 (n = 133, P = 0.03) in all lesions (black line). Sensitivity and specificity were 86% and 67%, 69% and 83%, and 56% and 66%, respectively. Red line represents receiver operating curve for random guess. At least 25% reduction in Δ-TLG was considered metabolic response. AUC = area under curve.
- FIGURE 5.
Number of previous treatments and their effect on response rate measured as Δ-TLG after 2 cycles of HER2-targeted treatment. One-way ANOVA showed significantly different response rates among 3 groups (P < 0.0001). Marker size reflects statistical weight of lesions per patient. P values represent Wilcoxon signed-rank test with regard to metabolic response among 3 groups.
Tables
HER2 status* Parameter Positive cases (n = 31) Negative cases (n = 6) Borderline cases (n = 3) Median age (y) 57 (29–89) 63 (45–78) 58 (53–62) Estrogen receptor–positive (≥10%) 14 (45%) 4 (67%) 2 (67%) Stage II 14 (45%) 0 1 (33%) III 2 (7%) 1 (17%) 0 IV 15 (48%) 5 (83%) 2 (67%) Molecular subtype Luminal A 1 (17%) Luminal B 3 (50%) 2 (67%) HER2-positive 17 (55%) HER2-positive/luminal 14 (45%) Triple-negative 2 (33%) 1 (33%) Neoadjuvant treatment Primary 15 (48%) 1 (17%) Metastatic 2 (6%) 1 (33%) Previous treatments PBC None 17 (55%) 1 (17%) 1 (33%) MBC None 1 (33%) 1 1 (3%) 1 (17%) 0 2 5 (16%) 2 (33%) 0 3 3 (10%) 0 0 4 2 (6%) 1 (17%) 0 5 1 (3%) 1 (17%) 0 6+ 2 (6%) 0 1 (33%) ↵* Based on immunohistochemistry and ISH results.
Qualitative data are number and percentage; continuous data are median and range.
- TABLE 2.
Anatomic Distribution and [68Ga]Ga-ABY-025 Mean SUVmax for Lesions Used in This Study
HER2 status Positive (n = 31) Negative (n = 6) Borderline (n = 3) Site of disease Number SUVmax Number SUVmax Number SUVmax Breast 26 (18) 10.1 ± 6.9 3 (1) 6.0 ± 2.4 2 (2) 6.8 ± 3.1 Axilla 22 (2) 10.9 ± 6.3 2 9.0 ± 3.7 — Liver 5 (3) 13.7 ± 6 6 (3) 18.1 ± 7 2 (1) 12.6 ± 10.5 Lung or distal lymph nodes 24 (5) 9.1 ± 7.4 3 5.3 ± 4.9 — Bone 16 (3) 16.2 ± 6.1 9 (1) 28 ± 14 4 11.9 ± 4.5 Other 8 15.8 ± 17 2 (1) 3.9 ± 0.4 — Number of biopsied lesions is in parentheses, 1 per patient. SUVmax is mean ± SD.
Supplemental Data
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