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Test Predicts If Breast Cancer Chemotherapy Will Work

RESTON, VA -- June 3, 2002 -- Resistance to chemotherapy is a major cause of treatment failure in patients with breast cancer. A study reported in the June issue of The Journal of Nuclear Medicine found that scintigraphic imaging with 99mTc-sestamibi accurately predicted which breast tumors would be chemoresistant.

The study was able to predict 100% of the time which patients would respond to chemotherapy, and 83% of the time which patients would not respond. Physicians in this phase II clinical trial studied 30 patients with untreated locally advanced breast cancer for whom a cycle of chemotherapy followed by surgery was planned. The patients received an injection of 99mTc-sestamibi and were scanned before treatment and again before surgery.

Those who were likely to respond had a low wash-out rate, or WOR (<45%) of the 99mTc-sestamibi. That means a higher amount of it remained in the body after injection, and showed up in the scan. Those unlikely to respond had a higher WOR (>45%). The authors pointed out that knowing a tumor was likely to be chemoresistant would allow physicians to prescribe specific drugs to boost the body's ability to respond to chemotherapy.

Results of the first test were analyzed to determine the amount of radiotracer uptake in the tumor at 10 minutes and 240 minutes, and the washout rate was calculated. The second scan was used diagnostically to confirm tumor response to treatment and the pretherapy therapy result. Results were also confirmed pathologically by the subsequent surgery. Scintigraphy is an imaging technique that uses radioisotopes and a gamma camera.

Prognostic Value of 99MTc-Sestamibi Washout in Predicting Response of Locally Advanced Beast Cancer to Neoadjuvant Chemotherapy was written by Rosa Sciuto, MD, Rosella Pasqualoni, MD, Serenella Bergomi, MD, German Petrilli, MD, Department of Nuclear Medicine, Patrizia Vici, MD, Franca Belli, MD, Second Department of Medical Oncology; Claudio Botti, MD, First Department of Surgical Oncology; Marcella Mottolese PhD, Department of Pathology; and Carlo L. Maini, MD, Department of Nuclear Medicine, all of Regina Elena Cancer Institute, Rome Italy.

Copies of the article and images related to the study are available to media upon request to Karen Lubieniecki at Karenlub@aol.com; (703) 683-0357. Copies of this and past issues of The Journal of Nuclear Medicine are available online at jnm.snmjournals.org. Print copies can be obtained at $15 per copy by contacting the SNM Service Center, Society of Nuclear Medicine, 1850 Samuel Morse Drive, Reston, VA 20190-5315; phone: (703) 326-1186; fax: (703) 708-9015; e-mail: servicecenter@snm.org. A yearly subscription to the journal is $170. A journal subscription is a member benefit of the Society of Nuclear Medicine.

SOURCE: Society of Nuclear Medicine

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