Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Breast Cancer
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1454844
This article is part of the Research Topic Multidisciplinary and Personalized Approach in the Treatment of Advanced Breast Cancer View all 13 articles

The role of FDG PET assessment in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 inhibitors in the second-line setting

Provisionally accepted
Marcin Kubeczko Marcin Kubeczko *Anna Polakiewicz-Gilowska Anna Polakiewicz-Gilowska Andrea D'Amico Andrea D'Amico Olgierd Chrabański Olgierd Chrabański Katarzyna Świderska Katarzyna Świderska Ewa Chmielik Ewa Chmielik Sławomir Blamek Sławomir Blamek Daria Handkiewicz-Junak Daria Handkiewicz-Junak Michał Jarząb Michał Jarząb
  • Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland

The final, formatted version of the article will be published soon.

    Background. Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have demonstrated a survival benefit in the second-line treatment of patients with hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. However, identifying prognostic biomarkers remains a challenge. Thus, we aimed to assess the prognostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) performed before CDK4/6 inhibitors initiation.Methods. This single-center retrospective analysis comprised patients treated with CDK4/6 inhibitors in the second-line setting between 2018 and 2024, with FDG-PET-CT performed before CDK4/6 inhibitor initiation.Results. The study included 39 patients with a median age of 63 years (IQR 50 -71). Among them, 12 had de novo metastatic disease (30.8%), and 13 had oligometastatic disease (33.3%). Treatment distribution was as follows: 15 patients palbociclib (38%), 19 ribociclib (49%), and five abemaciclib (13%). Most patients received fulvestrant (31 patients, 79%), whereas eight patients (21%) were treated with letrozole. The median progression-free survival (PFS) in all studied patients was 25.8 months. Notably, baseline SUVmax (maximum standardized uptake value) showed statistically and clinically significant differences. Patients in the low SUVmax group had a median PFS of 30.7 months, compared to 13.0 months for those in the high SUVmax group (p = 0.038). The 2-year PFS was 76.2% [95% CI 51.8% -89.4%] for the low SUVmax group, contrasting with 22.3% [95% CI 4.0% -49.9%] for the high SUVmax group. High SUVmax, poor performance status, and de novo metastatic disease were independent prognostic factors for PFS.Conclusions. FDG-PET-CT performed before cyclin-dependent kinase 4/6 inhibitor commencement is a valuable prognostic tool in hormone receptor-positive human epidermal growth factor receptor 2-negative advanced breast cancer. Patients with SUVmax less than 8.4 experienced extended progression-free survival compared to those with higher SUVmax.

    Keywords: Advanced breast cancer, 18Ffluorodeoxyglucose positron emission tomography, Palbociclib, Ribociclib, Abemaciclib

    Received: 25 Jun 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Kubeczko, Polakiewicz-Gilowska, D'Amico, Chrabański, Świderska, Chmielik, Blamek, Handkiewicz-Junak and Jarząb. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Marcin Kubeczko, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.