[89Zr]trastuzumab for PET imaging of HER2-positive lesions in patients with metastatic breast cancer

Eli C.F. Dijkers, Thijs H. Oude Munnink, Elisabeth G.E. De Vries, Adrienne H. Brouwers, Pieter L. Jager, Johan R. De Jong, Guus A.M.S. Van Dongen, Carolina P. Schröder, Marjolijn N. Lub-De Hooge, Jos G.W. Kosterink

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To investigate the use of [89Zr]trastuzumab for high-resolution, quantitative and sensitive HER2 PET imaging. A feasibility study was performed to determine optimal conditions of [89Zr]trastu-zumab dosage and timing of scans for visualization and quantification of HER2-positive lesions. DESIGN AND METHODS HER2-positive metastatic breast cancer patients received 37 MBq [89Zr]trastuzumab at three doses of trastuzumab: 10 or 50 mg when trastuzumab-naive and 10 mg trastuzumab while on trastuzumab treatment. Patients underwent ≥ PET scans around day 2 and 5 after [89Zr] trastuzumab injection. RESULTS 14 patients were included. The optimal moment to assess [89Zr]-trastuzumab tumour uptake was 4-5 days after tracer injection. Trastuzumab-naive patients required 50 mg [89Zr] trastuzumab and for patients on trastuzumab treatment 10 mg was adequate. [ 89Zr]trastuzumab PET imaging detected not only most of the known tumour lesions in liver, lung, bone and brain, but also unknown brain and bone lesions. The relative uptake values (mean ± SD) in liver, bone and brain lesions were 12.8 ± 5.8, 4.1 ± 1.6 and 3.5 ± 4.2, respectively, while relative uptake values in normal liver, spleen, kidneys and brain were 5.9 ± 4.2,2.8 ± 0.7, 4.0 ± 0.7 and 0.20 ± 0.1, respectively. CONCLUSION PET imaging of HER2 with [89Zr] trastuzumab can identify HER2-positive lesions in patients with HER2-positive metastatic breast cancer, when an appropriate antibody dose is used. In addition it allows quantification of [89Zr]trastuzumab uptake in these lesions.
Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalPharmaceutisch Weekblad
Issue number16
Publication statusPublished - 20-Apr-2012

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