scholarly journals STUDY OF CHANGES IN TUMOR BLOOD FLOW FOR THE ASSESSMENT OF EARLY RESPONSE TO NEOADJUVANT CHEMOTHERAPY IN BREAST CANCER PATIENTS

2020 ◽  
Vol 19 (6) ◽  
pp. 46-56
Author(s):  
M. V. Pavlov ◽  
P. I. Rykhtik ◽  
O. E. Ilyinskaya ◽  
P. V. Subochev ◽  
Yu. M. Kreinina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Flow ◽  
Neoadjuvant Chemotherapy ◽  
Doppler Ultrasound ◽  
Tumor Response ◽  
Pathological Response ◽  
Tumor Blood Flow ◽  
Tumor Vessels ◽  
Weak Response ◽  
Response To Neoadjuvant Chemotherapy

Background. Over the past 20 years, there has been a change in approaches to the treatment of breast cancer, in particular, a significant increase in the role of drug therapy. Breast cancer response to neoadjuvant chemotherapy is currently considered as a surrogate biomarker, which allows evaluation of the clinical course and prognosis of the disease. To solve this problem, it is necessary to assess the functional and metabolic changes in tumor tissue during treatment. Doppler ultrasound is a non-invasive, affordable, and low-cost imaging technique that can be safely used for repeated measurements.The purpose of the study was to study vascular changes in the tumor by power Doppler ultrasound for the evaluation of the early breast cancer response to neoadjuvant chemotherapy.Material and Methods. From May 2017 to August 2019, 63 patients with breast cancer received neoadjuvant chemotherapy. Changes in the tumor blood flow were assessed before starting the treatment and prior to the second course of neoadjuvant chemotherapy using Doppler scanning. Changes in tumor blood floor after chemotherapy were compared with the pathological tumor response after surgical treatment.Results. In the vast majority of cases (78 %), there was a decrease in the number of tumor vessels after the first cycle of neoadjuvant chemotherapy independent of the grade of pathological response. In 8 cases with increased vascularization after the first cycle of neoadjuvant chemotherapy, histological examination of the removed tumor showed no response / weak response to treatment in the absence of peritumoral inflammation. In 5 cases, a sharp increase in the number of vessels around large areas of intranodular necrosis and peritumoral inflammation was observed. In general, a comparison of changes in tumor vascularization and pathological response revealed a weak, although statistically significant, negative correlation between changes in the tumor blood flow after neoadjuvant chemotherapy and pathological response.Conclusion. It was not possible to establish an unambiguous relationship between the reaction of the vascular bed and the tumor response to the cytostatic effect. An increase in the number of tumor vessels in the absence of peritumoral inflammation was the only situation when changes in tumor blood flow during chemotherapy can be unambiguously interpreted as a predictive criterion for the absence / weak response of the tumor to treatment.

scholarly journals Exploratory Analysis of 18F-3’-deoxy-3’-fluorothymidine (18F-FLT) PET/CT-Based Radiomics for the Early Evaluation of Response to Neoadjuvant Chemotherapy in Patients With Locally Advanced Breast Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Lorenzo Fantini ◽  
Maria Luisa Belli ◽  
Irene Azzali ◽  
Emiliano Loi ◽  
Andrea Bettinelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Response ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathological Response ◽  
Textural Features ◽  
Flt Pet ◽  
Pet Ct ◽  
Response To Neoadjuvant Chemotherapy

PurposeThe objective of this study was to evaluate a set of radiomics-based advanced textural features extracted from 18F-FLT-PET/CT images to predict tumor response to neoadjuvant chemotherapy (NCT) in patients with locally advanced breast cancer (BC).Materials and MethodsPatients with operable (T2-T3, N0-N2, M0) or locally advanced (T4, N0-N2, M0) BC were enrolled. All patients underwent chemotherapy (six cycles every 3 weeks). Surgery was performed within 4 weeks of the end of NCT. The MD Anderson Residual Cancer Burden calculator was used to evaluate the pathological response. 18F-FLT-PET/CT was performed 2 weeks before the start of NCT and approximately 3 weeks after the first cycle. The evaluation of PET response was based on EORTC criteria. Standard uptake value (SUV) statistics (SUVmax, SUVpeak, SUVmean), together with 148 textural features, were extracted from each lesion. Indices that are robust against contour variability (ICC test) were used as independent variables to logistically model tumor response. LASSO analysis was used for variable selection.ResultsTwenty patients were included in the study. Lesions from 15 patients were evaluable and analyzed: 9 with pathological complete response (pCR) and 6 with pathological partial response (pPR). Concordance between PET response and histological examination was found in 13/15 patients. LASSO logistic modelling identified a combination of SUVmax and the textural feature index IVH_VolumeIntFract_90 as the most useful to classify PET response, and a combination of PET response, ID range, and ID_Coefficient of Variation as the most useful to classify pathological response.ConclusionsOur study suggests the potential usefulness of FLT-PET for early monitoring of response to NCT. A model based on PET radiomic characteristics could have good discriminatory capacity of early response before the end of treatment.

scholarly journals SCD5 Expression Correlates with Prognosis and Response to Neoadjuvant Chemotherapy in Breast Cancer

2020 ◽  
Author(s):  
Weipeng Zhao ◽  
Linlin Sun ◽  
Xichuan Li ◽  
Jun Wang ◽  
Ye Zhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Cycle ◽  
Neoadjuvant Chemotherapy ◽  
Pathological Response ◽  
Functional Enrichment ◽  
Integrated Analysis ◽  
Tumor Biomarker ◽  
Expression Signature ◽  
Response To Chemotherapy ◽  
Response To Neoadjuvant Chemotherapy

Abstract Neoadjuvant chemotherapy (NACT) represents a standard option for breast cancer. Unfortunately, about 55% to 80% of breast cancer patients do not have a favorable response to chemotherapy. Highly specific tumor biomarker that can predict the pathological response to neoadjuvant chemotherapy is lacking. Stearoyl-CoA desaturase 5 (SCD5) is an integral membrane protein of the endoplasmic reticulum that participates in lipid metabolism. However, the role of SCD5 in breast cancer remains unclear. Our study aims to understand its expression signature, prognosis value and correlation with pathological response to NACT in breast cancer using public databases. Analysis of samples from public databases showed that SCD5 expression was down-regulated across human cancers and associated with more aggressive breast cancer phenotypes. Survival analysis revealed that SCD5 expression was related to prognosis in breast cancer, especially triple-negative breast cancer (TNBC). Integrated analysis of multiple public datasets indicated that SCD5 expression signature was associated with response to NACT, particularly in TNBC. Based on functional enrichment analysis, SCD5 was implicated in pathways involved in metabolism and cell cycle. SCD5-related biological functions included negative regulation of cell cycle, cell division and DNA repair. Moreover, a significantly negative correlation between SCD5 expression and several cell cycle regulators was noted. Taken together, SCD5 was involved in the development and progression of breast cancer and might be a predictive biomarker for response to NACT. These results provided information for us to better understand SCD5 from the perspective of bioinformatics and highlighted the clinical importance of SCD5 in breast cancer, especially TNBC.

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