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Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
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Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
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Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
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Journal Article
Fluoroestradiol (FES) and Fluorodeoxyglucose (FDG) PET imaging in patients with ER+, HER2-positive or HER2-negative metastatic breast cancer
2025
Overview
Background
18
F-Fluorodeoxyglucose (FDG) and
18
F-Fluorestradiol (FES) have been FDA approved for measuring tumor glycolytic activity and estrogen receptor (ER) uptake, respectively, in clinical positron emission tomography (PET) imaging for patients with hormone-receptor (HR) positive metastatic breast cancer (MBC), but little is known about its utility in patients with breast tumors that overexpress human epidermal growth factor 2 (HER2). We hypothesize that comparing patterns of FDG and FES uptake in patients with HER2-positive versus HER2-negative MBC can guide further biologic and clinical studies into the HR/HER2-positive phenotype.
Methods
We conducted a retrospective study examining uptake in matched lesions for FES and FDG-PET scans, assessing these parameters in 213 patients with ER-positive/HER2-positive (
n
= 33) versus ER-positive/HER2-negative MBC (
n
= 180). We employed log-rank and t-tests to assess the association of HER2 status with outcome variables and the hypotheses that patients expressing HER2-positive disease lived longer than patient with HER2-negative disease.
Results
No difference in FES or FDG avidity was observed between patients with HER2-negative or HER2-positive tumor status. Limited data also suggests that patients with HER2-positive disease had better overall survival (
p
= 0.024), than those with HER2-negative disease, but not time-to-progression between the same patient cohorts.
Conclusion
This retrospective analysis suggests that there is a possible role for future trials using FES-PET in helping to select patients with ER+/HER2-positive primary tumors who retain ER expression at all sites of disease and may benefit from endocrine therapy.
Publisher
BioMed Central,Springer Nature B.V,BMC
Subject
/ Aged
/ Avidity
/ Biomedical and Life Sciences
/ Breast Neoplasms - diagnostic imaging
/ Breast Neoplasms - metabolism
/ Breast Neoplasms - mortality
/ Breast Neoplasms - pathology
/ Cancer
/ Estradiol - analogs & derivatives
/ FDG-PET
/ Female
/ FES-PET
/ HER2
/ Humans
/ Oncology
/ Patients
/ Positron emission tomography
/ Positron-Emission Tomography - methods
/ Receptor, ErbB-2 - metabolism
/ Receptors, Estrogen - metabolism
/ Scanners
/ Tumors
