Fiche publication


Date publication

mars 2020

Journal

Gynecologie, obstetrique, fertilite & senologie

Auteurs

Membres identifiés du Cancéropôle Est :
Dr ARNOULD Laurent , Dr COUDERT Bruno , Pr COUTANT Charles


Tous les auteurs :
Vincent L, Jankowski C, Arnould L, Coudert B, Rouzier R, Reyal F, Humbert O, Coutant C

Résumé

Objectives The aim of this study was to compare the value of F-fluorodesoxyglucose positron emission tomography (F-FDG PET/CT) with CGFL/Curie nomogram to predict a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in women with human epidermal growth factor 2 (HER2)-positive breast cancer treated by trastuzumab. Methods Fifty-one women with HER2-positive breast cancer treated with trastuzumab plus taxane-based NAC, were retrospectively included from January 2005 to December 2015. For F-FDG PET/CT, the analyzed predictor was the maximum standardized uptake value of the primary tumor and axillary nodes after the first course of NAC (PET.SUV). pCR was defined by no residual infiltrative tumor but in situ tumor was accepted. Accuracy of CGFL/Curie nomogram and PET.SUV was evaluated measuring sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). Combined prediction was evaluated testing predictor's associations. Results For CGFL/Curie nomogram's performances, Se, Sp, PPV and NPV were respectively: 76% (CI95%: 58-90%), 57% (CI95%: 43-66%), 55% (CI95%: 42-65), 77% (CI95%: 59-90%). For PET.SUV's performances, Se, Sp, PPV and NPV were respectively: 67% (CI95%: 48-81%), 77% (CI95%: 64-97%), 67% (CI95%: 48-82%), 77% (CI95%: 64-87%). ROC curves for these predictors were similar; the areas under the curve were 0.6 (CI95%: 0.56-0.64) for PET.SUV and 0.55 (CI95%: 0.50-0.59) for CGFL/Curie nomogram. Combined prediction was efficient with Se at 80%, VPN at 76%, Sp at 78% and VPP at 81 %. Conclusions CGFL/Curie nomogram and PET.SUV were two efficient predictors of pCR in patients with HER2-positive breast cancer. Combined prediction has an improved accuracy.

Mots clés

Breast Cancer, Cancer du sein, Chimiothérapie néoadjuvante, HER2, Pathologic complete response, Réponse histologique complete, neoadjuvant chemotherapy

Référence

Gynecol Obstet Fertil Senol. 2020 Mar 20;: