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Early Assessment Window for Predicting Breast Cancer Neoadjuvant Therapy using Biomarkers, Ultrasound, and Diffuse

Quing Zhu1,2, Foluso O Ademuyiwa3, Catherine Young4

  • 1Biomedical Engineering and Radiology, Washington University in St Louis, One Brookings Drive, Mail Box 1097, Whitaker Hall 200F, St. Louis, MO, 63130, USA. zhu.q@wustl.edu.

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Tumor biomarkers, ultrasound (US), and diffuse optical tomography (DOT) can accurately predict breast cancer response to neoadjuvant therapy (NAT) early in treatment. Combining these methods offers the best prediction of treatment effectiveness.

Keywords:
Near Infrared imagingPersonalized medicinePredicting neoadjuvant therapyUltrasound

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Area of Science:

  • Medical Imaging
  • Oncology
  • Biomarker Research

Background:

  • Early prediction of breast cancer response to neoadjuvant therapy (NAT) is crucial for optimizing treatment strategies.
  • Tumor biomarkers, ultrasound (US), and diffuse optical tomography (DOT) are potential tools for assessing treatment response.
  • This study aimed to evaluate the combined utility of these methods for early NAT response prediction.

Purpose of the Study:

  • To assess the utility of tumor biomarkers, ultrasound (US), and US-guided diffuse optical tomography (DOT) in the early prediction of breast cancer response to neoadjuvant therapy (NAT).

Main Methods:

  • Prospective study of 41 patients undergoing NAT, with imaging via US and US-guided DOT at baseline, mid-treatment, and pre-surgery.
  • Pathologic response assessed using Miller-Payne grading.
  • Receiver operating characteristic (ROC) curve analysis using logistic regression to determine the area under the curve (AUC) for prediction accuracy.

Main Results:

  • The combination of HER2/ER status, %HbT (end of cycle 1), and %US (end of cycle 1) achieved an AUC of 0.941 for early prediction.
  • US and DOT measurements (%US and %HbT at end of cycle 1) alone provided an AUC of 0.910, independent of biomarker status.
  • The highest prediction accuracy (AUC=0.974) was achieved using %US (end of cycle 1) and %HbT (end of cycle 3), irrespective of biomarker status.

Conclusions:

  • Combined use of tumor biomarkers (HER2, ER), US, and US-guided DOT can accurately predict NAT response.
  • Early prediction is possible as early as the completion of the first treatment cycle.
  • These imaging and biomarker combinations offer a promising approach for tailoring breast cancer treatment.