Early scan could help predict how well triple negative breast cancer responds to treatment
New research we helped fund has revealed that a scan taken after just 1 cycle of chemotherapy could indicate how well triple negative breast cancer is responding to treatment. And in the future, this could lead to improved treatment decisions.
Professors Andrew Tutt and Sheeba Irshad are world-class experts at the Breast Cancer Now Toby Robins Research Centre at the Institute of Cancer Research, London, and the Breast Cancer Now Research Unit at Kings College London.
Their latest findings, published in Clinical Cancer Research, could help doctors ensure everyone going through treatment for triple negative breast cancer gets the right treatment at the right time.
Why triple negative breast cancer can be hard to treat
The study focused on people diagnosed with triple-negative breast cancer. Unlike other types of breast cancer, triple negative disease lacks targeted treatments.
People with triple negative breast cancer are usually treated with chemotherapy before their surgery. Sometimes, the tumour responds so well, that there’s no detectable cancer by the time of surgery. But if triple negative breast cancer cells still remain 6 months later at the time of surgery, this is associated with a worse outlook.
To tackle this, our researchers have been looking for ways to find out earlier whether treatment is working. If they can do that, it could help doctors make vital treatment decisions sooner.
Spotting treatment response earlier
The research explored the benefits of using a PET scan shortly after treatment begins rather than relying only on MRI scans later in the treatment process. They wanted to find out if this could provide earlier insights into how a patient’s cancer is responding.
22 patients took part in the study, and 14 of them had PET scans before treatment and after the first cycle of chemotherapy.
Results showed that changes seen on PET scans after just one cycle were strongly linked to how well the cancer responded by the end of treatment. This included whether someone went on to achieve a complete response, meaning they had no detectable cancer by the end of treatment. And importantly, the researchers showed that early response seen in PET scans was better at predicting treatment success than standard mid-treatment MRI scans.
In patients who had PET scans both before treatment and after the first cycle, we found that this early scan could predict whether they were likely to achieve a complete response by the end of treatment. These findings highlight the potential of early scans to guide treatment decisions, and now need to be validated in larger, modern clinical trials.
Predicting who could benefit
Being able to identify cancers that aren’t responding well at an early stage could allow doctors to adjust treatment sooner or consider alternatives. In the future, it could help to better tailor treatment for each person.
Research that helps us determine early who is already benefitting from standard neoadjuvant chemotherapy and who might benefit from clinical trials to find better treatments is vital. This study shows that FDG CT-PET may have great value in this regard. We hope to be able to design studies that further investigate and validate these findings.
Looking ahead
The researchers also explored how changes seen in PET scans after just 1 cycle of chemotherapy relate to the body’s immune response to treatment. They took biopsies before and after the first cycle of chemotherapy. Their findings showed that having more immune cells within the tumour was linked to both early changes seen in PET scans and improved treatment outcomes later down the line.
This suggests early scans could give researchers useful clues about how the immune system is responding too.
Now, we need larger studies with broader groups of patients to confirm these observations. Future research will also aim to explore more accessible ways to monitor treatment response, such as ultrasound., This could reveal a better alternative to alongside PET and MRI scans, which can be more expensive, time-consuming and require specialist equipment and staff.
This study was supported by funding from Breast Cancer Now, King’s College London, Cancer Research UK and GSTT Charity.
The Breast Cancer Now Research Unit at King’s College London is supported by the Asda Tickled Pink campaign and Omaze is the flagship funder of the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research, London.
Help fund our research
Over 8000 women a year are diagnosed with triple negative breast cancer in the UK alone. To help us continue funding research that aims to improve survival rates and develop effective treatments, please consider donating.