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472 Utility of [89Zr]Trastuzumab-PET/MRI Imaging for Quantitative Assessment of Tumor Heterogeneity In HER2+ Breast Cancer

Published online by Cambridge University Press:  03 April 2024

Ameer Mansur
Affiliation:
University of Alabama at Birmingham
Moozhan Nikpanah
Affiliation:
Department of Radiology, UAB
Johnathan McConathy
Affiliation:
Department of Radiology, UAB O’Neal Comprehensive Cancer Center, UAB
Erica Stringer-Reasor
Affiliation:
Department of Radiology, UAB
Gabrielle Rocque
Affiliation:
Division of Hematology and Oncology, UAB
Ahmed Elkhanany
Affiliation:
O’Neal Comprehensive Cancer Center, UAB
Katia Khoury
Affiliation:
O’Neal Comprehensive Cancer Center, UAB
Nusrat Jahan
Affiliation:
O’Neal Comprehensive Cancer Center, UAB
Suzanne E. Lapi
Affiliation:
Department of Chemistry, UAB
Anna G. Sorace
Affiliation:
Department of Radiology, UAB O’Neal Comprehensive Cancer Center, UAB Department of Biomedical Engineering, UAB
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Abstract

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OBJECTIVES/GOALS: This study was performed to explore the capabilities of simultaneous [89 Zr]trastuzumab-PET/MRI acquisition in a cohort of metastatic HER2+ breast cancer. The insights derived provide additional noninvasive characterization and precise intratumoral analysis tools for healthcare providers. METHODS/STUDY POPULATION: A total of 13 patients, aged between 40 and 70, diagnosed with HER2-positive breast cancer, were selected to participate in this study. Whole-body [89 Zr]trastuzumab-PET/MR imaging was performed 5 ± 1 days post-injection of the radiopharmaceutical during ongoing HER2-directed therapy. Concurrently acquired T1-weighted MRI facilitated the identification of normal organ and tumor regions of interest, which were further analyzed for mean ADC and mean standardized uptake value. Multiparametric intratumoral habitat analysis was performed. Utilizing the median metric values, tumors were evaluated for heterogeneity, specifically assessing high and low HER2 expression through an image processing framework in conjunction with ADC metrics. Long-term treatment response evaluation is ongoing. RESULTS/ANTICIPATED RESULTS: Initial analysis indicate all tumors exhibited higher overall uptake of [89 Zr]trastuzumab across various sites including the bone (p=0.019), brain (p=0.014), and breast (p=0.069), when compared to corresponding normal organs. Additionally, increased ADCmean values were observed in all regions besides brain tumors (bone: p=0.002, brain: p=0.5, breast: p=0.03, juxtapulmonary: p=0.037), indicating distinct patterns of cellularity. Notably, one of five patients with a breast lesion, who exhibited a complete response to HER2-targeted therapy, exhibited the highest breast lesion SUVmean. Brain and lymph node lesions demonstrated intratumoral heterogeneity of HER2 expression. Qualification of multi parametric maps is anticipated to inform on intratumoral heterogeneity DISCUSSION/SIGNIFICANCE: Despite limitation in clinical applications of quantitative approaches due to lack of standardization of processing, initial investigations, in combining molecular imaging of HER2 and quantitative MRI demonstrate potential in characterizing metastatic HER2+ breast cancer for intratumoral classification and therapeutic stratification.

Type
Precision Medicine/Health
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2024. The Association for Clinical and Translational Science