Could HER2 heterogeneity open new therapeutic options in patients with HER2- primary breast cancer
Technical Report,30 Sep 2016,29 Sep 2017
Memorial Sloan Kettering Cancer Center AND ADDRE United States
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The purpose of this study is to determine if targeted imaging with a HER2-targeting PET tracer can detect HER2-positive metastases in patients with HER2-negative primary breast cancer. Twenty-three patients have been accrued to the trial using 89Zr-trastuzumab as the imaging agent. Nine patients demonstrated suspicious foci on 89Zr-trastuzumab PETCT. Three of nine patients with suspicious foci have now been found to have biopsy-proven HER2-positive metastases. Thus, 89Zr-trastuzumab PETCT may detect HER2-positive metastases in patients with presumed HER2-negtive primary breast cancer. This is an initial proof-of-concept that targeted imaging may help identify patients eligible for targeted therapies. However, six of nine patients have had biopsies demonstrating HER2-negative metastases, despite 89Zr-trastuzumab positivity. Two manuscripts have been published on the work with 89Zr-trastuzumab. These false-positive results limit the ability of 89Zr-trastuzumab to be translated into clinical use and a more specific radiotracer will be needed. A first-in-human trial of 89Zr-pertuzumab PETCT was performed in six patients with HER2-positive metastatic breast cancer, demonstrating safety, dosimetry, and effectiveness of 89Zr-pertuzumab to image HER2-positive disease. One manuscripts has been submitted for publication on the work with 89Zr-pertuzumab. We will now return to evaluating patients with HER2-negative primary breast cancer, using 89Zr-pertuzumab as the imaging agent.
- Medicine and Medical Research