PT  - JOURNAL ARTICLE
AU  - Garcia-Velloso, Maria J.
AU  - Boni, Valentina
AU  - Dominguez-Prado, Ines
AU  - Marti-Climent, Josep
AU  - Lopez-Vega, Jose
AU  - Martinez, Purificacion
AU  - Plazaola, Arrate
AU  - Garcia-Foncillas, Jesus
AU  - Peñuelas, Ivan
AU  - Richter, Jose
TI  - Imaging early changes in proliferation during Bevacizumab therapy in locally advanced breast cancer with 18F-FLT PET/CT
DP  - 2011 May 01
TA  - Journal of Nuclear Medicine
PG  - 367--367
VI  - 52
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/52/supplement_1/367.short
4100  - http://jnm.snmjournals.org/content/52/supplement_1/367.full
SO  - J Nucl Med2011 May 01; 52
AB  - 367 Objectives To investigate the effect of Bevacizumab on tumor proliferation by assessment metabolic changes with 18F-FLT PET/CT in patients with locally advanced breast cancer (Imaging Clinical Trial). Methods Forty-six untreated patients with locally advanced breast cancer underwent 18F-FLT PET/CT before and after a dose of Bevacizumab. Uptake of 18F-FLT in tumor was analyzed visually and the maximum SUV was calculated. Tumor biopsies were obtained before and after treatment. The association of 18F-FLT uptake with clinicopathologic characteristics and with Ki-67 proliferation index was studied. Results 18F-FLT uptake was visualized in 43 (93%) tumors. An association of baseline SUV values with histopathological tumor grading (G1-G2=2.2, G3-G4=3.6;p=0.03), clinical stage (II vs III, 2.6 vs 4.3, p<0.01) and estrogen receptors (ER) status (ER+ vs ER− 2.6 vs 3.5, p=0.08) was observed. Mean SUV in the primary tumors before and after Bevacizumab were significantly different (3.1±1.6 vs 2.2±1.5, p<0.01) with a >30% decrease in 20 patients. The change of 18F-FLT SUV after bevacizumab correlated with the change of the Ki-67 index (rho=0.33;p=0.03). In 14 patients, the axillary lymph node status was also evaluated and showed a positive uptake (mean SUV 3.3±1.7). After treatment the nodal uptake decreased significantly (SUV 2.3±1.6, p<0.01) with a >30% decrease in 6 patients. Conclusions 18F-FLT showed an excellent sensitivity to detect breast cancer and was associated with important clinicopathologic characteristics such as tumor grade, hormonal status and clinical stage. An anti-proliferative effect of Bevacizumab in both tumors and lymph node metastasis was observed. The change of FLT correlated with the change of Ki-67 index confirming the 18F-FLT PET imaging as a proliferation biomarker. 18F-FLT appears to be a promising tracer of bevacizumab response in breast cancer