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Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After
Mingxi Zhu1, Qiong Wu1, Xiaochuan Geng2
1Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
Current Oncology (Toronto, Ont.)
|February 25, 2025
Summary
Tumor heterogeneity quantified by magnetic resonance imaging (MRI) can predict treatment response in breast cancer patients receiving neoadjuvant chemotherapy (NAC). Lower heterogeneity indicates a better pathological complete response (pCR), aiding precision medicine approaches.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Breast tumor heterogeneity is linked to treatment sensitivity.
- Predicting response to neoadjuvant chemotherapy (NAC) is crucial for personalized treatment.
Purpose of the Study:
- To develop a predictive model for pathological complete response (pCR) to NAC using MRI-quantified tumor heterogeneity.
- To assess the prognostic value of heterogeneity patterns during NAC.
Main Methods:
- Retrospective analysis of 217 invasive breast cancer patients undergoing MRI before and after NAC.
- Quantification of tumor heterogeneity using MRI image processing algorithms.
- Development and validation of predictive models combining heterogeneity and clinical factors.
Main Results:
- Lower tumor heterogeneity was significantly associated with pCR (OR, 0.401; p=0.007).
- A combined model improved specificity (0.857) and accuracy (0.828) over a clinical model alone.
- Heterogeneity patterns during NAC influenced survival outcomes, with the low-heterogeneity group faring best.
Conclusions:
- Quantified MRI tumor heterogeneity is a non-invasive predictor of pCR to NAC.
- This approach supports the implementation of precision medicine in breast cancer treatment.
- Monitoring heterogeneity changes during NAC offers prognostic information and aids treatment strategy adjustments.
