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Initial Clinical Results of a Novel Immuno-PET Theranostic Probe in HER2-negative Breast Cancer

Caroline Rousseau 1 David Goldenberg 2, 3 Mathilde Colombié 4, 5 Jean-Charles Sébille 4, 5 Philippe Meingan 4, 6 Ludovic Ferrer 1, 7, 4 Pierre Baumgartner 4, 8 Evelyne Cerato 9 Damien Masson 10 Mario Campone 11, 4, 12 Aurore Rauscher 8 Vincent Fleury 5 Catherine Labbé 6 Alain Faivre-Chauvet 5, 12 Jean-Sebastien Fresnel 4, 11 Claire Toquet 13 Jacques Barbet 14 Robert Sharkey 3 Loïc Campion 15, 16 Françoise Kraeber-Bodéré 1, 5, *
Abstract : Purpose: This prospective study evaluated the imaging performance of a novel immunological pretargeting positron-emission tomorgraphy (immuno-PET) method in patients with HER2-negative, carcinoembryonic antigen (CEA)-positive, metastatic breast cancer (BC), compared to computed tomography (CT), bone magnetic resonance imaging (MRI), and 18Fluorodeoxyglucose PET (FDG-PET). Patients and Methods: Twenty-three patients underwent whole-body immuno-PET after injection of 150 MBq 68Ga-IMP288, a histamine-succinyl-glycine peptide given following initial targeting of a trivalent anti-CEA, bispecific, anti-peptide antibody. The gold standards were histology and imaging follow-up. Tumor standard uptake values (SUVmax and SUVmean) were measured, and tumor burden analyzed using Total Tumor Volume (TTV) and Total Lesion Activity (TLA). Results: Total lesion sensitivity of immuno-PET and FDG-PET was 94.7% (1116/1178) and 89.6% (1056/1178), respectively. Immuno-PET had a somewhat higher sensitivity than CT and FDG-PET in lymph nodes (92.4% vs 69.7% and 89.4%, respectively) and liver metastases (97.3% vs 92.1% and 94.8%, respectively), whereas sensitivity was lower for lung metastases (48.3% vs 100% and 75.9%, respectively). Immuno-PET showed higher sensitivity than MRI and FDG-PET for bone lesions (95.8% vs 90.7% and 89.3%, respectively). In contrast to FDG-PET, immuno-PET disclosed brain metastases. Despite equivalent tumor SUVmax, SUVmean, and TTV, TLA was significantly higher with immuno-PET compared to FDG PET (P = 0.009). Conclusion: Immuno-PET using anti-CEA/anti-IMP288 bispecific antibody, followed by 68Ga-IMP288, is a potentially sensitive theranostic imaging method for HER2-negative, CEA-positive, metastatic BC patients, and warrants further research.
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Caroline Rousseau, David Goldenberg, Mathilde Colombié, Jean-Charles Sébille, Philippe Meingan, et al.. Initial Clinical Results of a Novel Immuno-PET Theranostic Probe in HER2-negative Breast Cancer. Journal of Nuclear Medicine, Society of Nuclear Medicine, 2020, pp.jnumed.119.236000. ⟨10.2967/jnumed.119.236000⟩. ⟨inserm-02512957⟩

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