Anjali Jain1*, Sameer Raniga2, Alok Kumar Mittal2, Khalid Al Baimani1 and Subhash Kheruka1
1Department of Cancer, Sultan Qaboos Comprehensive Cancer Care and Research Centre, Oman 2Department of Cancer, Sultan Qaboos University Hospital, OmanFulltext PDF
Background: RECIST 1.1 is widely used in treatment response evaluation of breast cancer, although it considers certain lesion as non-measurable which constitute major disease burden. FDG PETCT has the ability to quantitatively measure response in this category causing change in management. Objectives: 1) To compare PERCIST 1.0 with RECIST 1.1 in quantifying the treatment response of the locally advanced, metastatic and recurrent breast cancer. 2) To evaluate difference in RECIST 1.1 and PERCIST 1.0 criteria in patients with non-measurable disease over measurable disease. Methods: This retrospective study was conducted on 45 patients of locally advanced, recurrent or metastatic breast cancer patients between April 2016 to March 2017. Treatment response was evaluated on baseline and post-treatment FDG PET/CT scans and compared between RECIST 1.1 and PERCIST 1.0. Difference in response between RECIST 1.1 and PERCIST 1.0 was also compared in two groups of patients 1) non-measurable and 2) mixed disease (non-measurable and measurable) as defined by RECIST 1.1. Results: Discordant response between RECIST 1.1 and PERCIST 1.0 was seen in 28.8% of patients and all of them belonged to stable disease with RECIST 1.1, but with PERCIST 1.0, 11.1% showed CMR, 4.4% PMR while 13.3% PMD. Based on RECIST 1.1, on further dividing the patients into two categories of non-measurable disease only and mixed disease, discordant results was seen in category of non-measurable disease only. 50% of patients in non-measurable disease only category showed change in response between RECIST 1.1 and PERCIST 1.0 and 70% of patients with bone metastases showed significant change in response with P value: 0.002. Conclusion: PERCIST 1.0 is superior to RECIST 1.1 in quantitative response evaluation in locally advanced, recurrent and metastatic breast cancer, especially in patients with non-measurable disease mainly bony metastatic disease. All patients with non-measurable disease should be evaluated with FDG PET/CT rather than CT. Clinical Impact: All patients with non-measurable disease on CT scan can be directed to FDG PET/ CT staging and response evaluation, which would lead to adequate management of these patients with appropriate use of resources. Key Findings: 28% of patients showed discordant results between RECIST 1.1 and PERCIST 1.0 and all of them were having non-measurable disease only. 50% of patients with non-measurable disease and 70% of patients with bone metastases showed discordant results between RECIST 1.1 and PERCIST 1.0. Importance: Significant number of patients with non-measurable disease showed change in response from RECIST 1.1 to PERCIST 1.0 and should be evaluated with PET scan.
RECIST 1.1; PERCIST 1.0; FDG PET/CT; Breast cancer
Jain A, Raniga S, Mittal AK, Al Baimani K, Kheruka S. PERCIST 1.0 Versus RECIST 1.1 in the Evaluation of Locally Advanced and Metastatic Breast Cancer: An Observational Study. World J Breast Cancer Res. 2022; 5(1): 1023.