TY - JOUR T1 - TBCRC 008: Early Change in <sup>18</sup>F-FDG Uptake on PET Predicts Response to Preoperative Systemic Therapy in Human Epidermal Growth Factor Receptor 2–Negative Primary Operable Breast Cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 31 LP - 37 DO - 10.2967/jnumed.114.144741 VL - 56 IS - 1 AU - Roisin M. Connolly AU - Jeffrey P. Leal AU - Matthew P. Goetz AU - Zhe Zhang AU - Xian C. Zhou AU - Lisa K. Jacobs AU - Joyce Mhlanga AU - Joo H O AU - John Carpenter AU - Anna Maria Storniolo AU - Stanley Watkins AU - John H. Fetting AU - Robert S. Miller AU - Kostandinos Sideras AU - Stacie C. Jeter AU - Bridget Walsh AU - Penny Powers AU - Jane Zorzi AU - Judy C. Boughey AU - Nancy E. Davidson AU - Lisa A. Carey AU - Antonio C. Wolff AU - Nagi Khouri AU - Edward Gabrielson AU - Richard L. Wahl AU - Vered Stearns Y1 - 2015/01/01 UR - http://jnm.snmjournals.org/content/56/1/31.abstract N2 - Epigenetic modifiers, including the histone deacetylase inhibitor vorinostat, may sensitize tumors to chemotherapy and enhance outcomes. We conducted a multicenter randomized phase II neoadjuvant trial of carboplatin and nanoparticle albumin-bound paclitaxel (CP) with vorinostat or placebo in women with stage II/III, human epidermal growth factor receptor 2 (HER2)–negative breast cancer, in which we also examined whether change in maximum standardized uptake values corrected for lean body mass (SULmax) on 18F-FDG PET predicted pathologic complete response (pCR) in breast and axillary lymph nodes. Methods: Participants were randomly assigned to 12 wk of preoperative carboplatin (area under the curve of 2, weekly) and nab-paclitaxel (100 mg/m2 weekly) with vorinostat (400 mg orally daily, days 1–3 of every 7-d period) or placebo. All patients underwent 18F-FDG PET and research biopsy at baseline and on cycle 1 day 15. The primary endpoint was the pCR rate. Secondary objectives included correlation of change in tumor SULmax on 18F-FDG PET by cycle 1 day 15 with pCR and correlation of baseline and change in Ki-67 with pCR. Results: In an intent-to-treat analysis (n = 62), overall pCR was 27.4% (vorinostat, 25.8%; placebo, 29.0%). In a pooled analysis (n = 59), we observed a significant difference in median change in SULmax 15 d after initiating preoperative therapy between those achieving pCR versus not (percentage reduction, 63.0% vs. 32.9%; P = 0.003). Patients with 50% or greater reduction in SULmax were more likely to achieve pCR, which remained statistically significant in multivariable analysis including estrogen receptor status (odds ratio, 5.1; 95% confidence interval, 1.3–22.7; P = 0.023). Differences in baseline and change in Ki-67 were not significantly different between those achieving pCR versus not. Conclusion: Preoperative CP with vorinostat or placebo is associated with similar pCR rates. Early change in SULmax on 18F-FDG PET 15 d after the initiation of preoperative therapy has potential in predicting pCR in patients with HER2-negative breast cancer. Future studies will further test 18F-FDG PET as a potential treatment-selection biomarker. ER -