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Radiolabelled Trastuzumab PET/CT imaging: a promising non-invasive tool for the in vivo assessment of HER2 status in breast cancer patients

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Abstract

Purpose

In patients with breast cancer, the overexpression of human epidermal growth factor receptor 2 (HER2) is associated with a worse prognosis and a better response to target therapy with monoclonal antibody, such as trastuzumab. HER2 status is usually revealed by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH) on tumour tissue sample. Recently, PET/CT with radiolabelled trastuzumab has been described as a non-invasive tool for the identification of HER2-positive lesions in patients with BC, with a potential role in the selection of patients candidates to target therapy. The purpose of this mini-review of current literature is to summarize the state of the art of PET/CT imaging with these new radiopharmaceuticals.

Methods

PubMed/MEDLINE database was screened to find articles regarding the role of radiolabelled trastuzumab PET/CT in detecting HER2-positive breast cancer lesions. Terms breast cancer AND (PET OR positron emission tomography) AND (trastuzumab OR radiolabelled monoclonal) were used.

Results

Fourteen studies exploring the role of radiolabelled trastuzumab PET/CT in BC patients were included. Three different radiopharmaceuticals were used (89Zr-Trastuzumab, 64Cu-Trastuzumab and 68Ga-DOTA-F(abʹ)2-Trastuzumab). Clinical data were not available for all studies and quite heterogeneous within the same studies; methodological aspects were also quite different among studies, while the comparison with conventional imaging techniques was common.

Conclusion

Additional studies are needed to validate the potential role of radiolabelled trastuzumab PET/CT, demonstrating its effectiveness in detection of HER2-positive lesions and in identification of BC patients who could benefit from specific and personalized therapy.

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Authors and Affiliations

  1. Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Francesco Vito, 1, 00168, Rome, Italy

    Margherita Lorusso, Valentina Scolozzi, Silvia Taralli, Carmelo Caldarella & Maria Lucia Calcagni

  2. Unità Operativa di Medicina Nucleare, Dipartimento Interdisciplinare di Medicina, Università degli Studi di Bari “Aldo Moro”-AOU Policlinico di Bari, Bari, Italy

    Corinna Altini & Giuseppe Rubini

  3. Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy

    Maria Lucia Calcagni

Authors
  1. Margherita Lorusso
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  2. Valentina Scolozzi
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  3. Silvia Taralli
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Contributions

ML and VS performed conception and design of the article, literature search and analysis, manuscript writing and critical revision; ST and CC performed literature search and analysis and manuscript writing; CA and GR performed literature search and critical revision; and MLC performed conception and design of the article, manuscript writing and critical revision. All the authors approved the final version of the article.

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Correspondence to Valentina Scolozzi.

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Lorusso, M., Scolozzi, V., Taralli, S. et al. Radiolabelled Trastuzumab PET/CT imaging: a promising non-invasive tool for the in vivo assessment of HER2 status in breast cancer patients. Clin Transl Imaging 8, 95–105 (2020). https://doi.org/10.1007/s40336-020-00362-4

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