Abstract：
BACKGROUND: Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by the absence of estrogen, progesterone, and HER2 receptors. It predominantly affects younger women and is associated with a poor prognosis. This systematic review aims to evaluate the current role of positron emission tomography (PET) in the management of TNBC patients and to identify future research directions.
METHODS: We systematically searched the PubMed, Scopus, and Web of Science databases up to February 2024. A team of five researchers conducted data extraction and analysis. The quality of the selected studies was assessed using a specific evaluation form.
RESULTS: Twenty-eight studies involving 2870 TNBC patients were included in the review. Key clinical applications of PET in TNBC included predicting pathological complete response (pCR) in patients undergoing neoadjuvant chemotherapy (NAC), assessing the prognostic value of baseline PET, and initial disease staging. Two studies utilized PSMA-ligand agents, while the majority used [18F]FDG-based PET. Significant associations were found between baseline [18F]FDG uptake and molecular biomarkers such as PDL-1, androgen receptor, and Ki67. Baseline [18F]FDG PET led to the upstaging of patients from stage IIB to stage IV, influencing treatment decisions and survival outcomes. In the NAC setting, serial PET scans measuring changes in [18F]FDG uptake, indicated by maximum standardized uptake value (SUVmax), predicted pCR with varying cut-off values correlated with different response rates. Semiquantitative parameters such as metabolic tumor volume (MTV) and PET lung index were prognostic for metastatic disease.
CONCLUSIONS: In TNBC patients, [18F]FDG PET is essential for initial disease staging in both localized and metastatic settings. It is also useful for assessing treatment response to NAC. The ability of PET to correlate metabolic activity with molecular markers and predict treatment outcomes highlights its potential in TNBC management. Further prospective studies are needed to refine these clinical indications and establish its definitive role.
METHODS: We systematically searched the PubMed, Scopus, and Web of Science databases up to February 2024. A team of five researchers conducted data extraction and analysis. The quality of the selected studies was assessed using a specific evaluation form.
RESULTS: Twenty-eight studies involving 2870 TNBC patients were included in the review. Key clinical applications of PET in TNBC included predicting pathological complete response (pCR) in patients undergoing neoadjuvant chemotherapy (NAC), assessing the prognostic value of baseline PET, and initial disease staging. Two studies utilized PSMA-ligand agents, while the majority used [18F]FDG-based PET. Significant associations were found between baseline [18F]FDG uptake and molecular biomarkers such as PDL-1, androgen receptor, and Ki67. Baseline [18F]FDG PET led to the upstaging of patients from stage IIB to stage IV, influencing treatment decisions and survival outcomes. In the NAC setting, serial PET scans measuring changes in [18F]FDG uptake, indicated by maximum standardized uptake value (SUVmax), predicted pCR with varying cut-off values correlated with different response rates. Semiquantitative parameters such as metabolic tumor volume (MTV) and PET lung index were prognostic for metastatic disease.
CONCLUSIONS: In TNBC patients, [18F]FDG PET is essential for initial disease staging in both localized and metastatic settings. It is also useful for assessing treatment response to NAC. The ability of PET to correlate metabolic activity with molecular markers and predict treatment outcomes highlights its potential in TNBC management. Further prospective studies are needed to refine these clinical indications and establish its definitive role.
摘要：
背景：三阴性乳腺癌（TNBC）是一种以缺乏雌激素为特征的乳腺癌亚型，黄体酮,和HER2受体。它主要影响年轻女性，并与不良预后有关。本系统综述旨在评估正电子发射断层扫描（PET）在TNBC患者管理中的当前作用，并确定未来的研究方向。
方法：我们系统地搜索了PubMed，Scopus,和截至2024年2月的WebofScience数据库。由五名研究人员组成的团队进行了数据提取和分析。使用特定的评估表评估所选研究的质量。
结果：28项研究纳入了2870例TNBC患者。PET在TNBC中的关键临床应用包括预测接受新辅助化疗（NAC）的患者的病理完全缓解（pCR），评估基线PET的预后价值，和最初的疾病分期。两项研究利用PSMA-配体试剂，而大多数使用基于[18F]FDG的PET。发现基线[18F]FDG摄取和分子生物标志物如PDL-1，雄激素受体，Ki67基线[18F]FDGPET导致患者从IIB期至IV期，影响治疗决策和生存结果。在NAC设置中，连续PET扫描测量[18F]FDG摄取的变化，用最大标准化摄取值(SUVmax)表示，具有不同截止值的预测pCR与不同的应答率相关。半定量参数如代谢性肿瘤体积（MTV）和PET肺指数是转移性疾病的预后。
结论：在TNBC患者中，[18F]FDGPET对于局部和转移性环境中的初始疾病分期至关重要。它也可用于评估对NAC的治疗反应。PET将代谢活性与分子标志物相关联并预测治疗结果的能力突出了其在TNBC管理中的潜力。需要进一步的前瞻性研究来完善这些临床适应症并确定其明确的作用。
方法：我们系统地搜索了PubMed，Scopus,和截至2024年2月的WebofScience数据库。由五名研究人员组成的团队进行了数据提取和分析。使用特定的评估表评估所选研究的质量。
结果：28项研究纳入了2870例TNBC患者。PET在TNBC中的关键临床应用包括预测接受新辅助化疗（NAC）的患者的病理完全缓解（pCR），评估基线PET的预后价值，和最初的疾病分期。两项研究利用PSMA-配体试剂，而大多数使用基于[18F]FDG的PET。发现基线[18F]FDG摄取和分子生物标志物如PDL-1，雄激素受体，Ki67基线[18F]FDGPET导致患者从IIB期至IV期，影响治疗决策和生存结果。在NAC设置中，连续PET扫描测量[18F]FDG摄取的变化，用最大标准化摄取值(SUVmax)表示，具有不同截止值的预测pCR与不同的应答率相关。半定量参数如代谢性肿瘤体积（MTV）和PET肺指数是转移性疾病的预后。
结论：在TNBC患者中，[18F]FDGPET对于局部和转移性环境中的初始疾病分期至关重要。它也可用于评估对NAC的治疗反应。PET将代谢活性与分子标志物相关联并预测治疗结果的能力突出了其在TNBC管理中的潜力。需要进一步的前瞻性研究来完善这些临床适应症并确定其明确的作用。
