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Breast cancer

Predicting nonresponders—light at the end of the PET tunnel

Nature Reviews Clinical Oncology volume 12, page 2 (2015)Cite this article

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The addition of trastuzumab—a monoclonal antibody that targets the HER2 receptor—to docetaxel chemotherapy in the neoadjuvant treatment of patients with HER2-positive (HER2+) breast cancer leads to a higher proportion of pathological complete responses (pCRs) compared with chemotherapy alone, and is regarded as the standard of care for this patient subgroup. Other treatment options, however, are needed for patients who do not achieve a pCR in this setting. Now, Bruno Coudert and colleagues have reported the results of the AVATAXHER phase II trial, which provides another option for patients with HER2+ breast cancer who do not respond to neoadjuvant therapy.

The researchers enrolled 142 patients with early-stage, HER2+ breast cancer and showed that early assessment with 18F-fluorodeoxyglucose PET (FDG-PET), after one treatment cycle, can predict a pCR to the neoadjuvant treatment—leading to the identification of patients who will probably not respond to treatment (nonresponders). Of the 142 patients, 69 were predicted as treatment responders, 37 of whom went on to achieve a confirmed pCR. The 73 remaining nonresponders were randomly assigned (2:1) to receive docetaxel and trastuzumab with or without the angiogenesis inhibitor bevacizumab.

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References

  1. Coudert, B. et al. Use of [18F]-FDG PET to predict response to neoadjuvant trastuzumab and docetaxel in patients with HER2-positive breast cancer, and addition of bevacizumab to neoadjuvant trastuzumab and docetaxel in [18F]-FDG PET-predicted non-responders (AVATAXHER): an open-label, randomised phase 2 trial. Lancet Oncol. 10.1016/S1470-2045(14)70475-9

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Authors
  1. Alessia Errico
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Errico, A. Predicting nonresponders—light at the end of the PET tunnel. Nat Rev Clin Oncol 12, 2 (2015). https://doi.org/10.1038/nrclinonc.2014.203

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  • DOI: https://doi.org/10.1038/nrclinonc.2014.203

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