Imaging May Predict Which Breast Cancers Will Respond To Chemotherapy

MedicalResearch.com Interview with:
Shidong Jiang
Associate professor of Engineering
Thayer School of Engineering at Dartmouth

Medical Research: What is the background for this study? What are the main findings?

Dr. Jiang: Breast cancer is the most common non-skin cancer in women worldwide, and the second leading cause of women’s cancer mortality in the United States. A common treatment strategy after diagnosis is to shrink breast cancer tumors larger than 3 centimeters with a 6 to 8 month course of Neoadjuvant Chemotherapy prior to surgery. Clinical studies have shown that patients who respond to Neoadjuvant Chemotherapy have longer disease-free survival rates, but only 20 to 30 percent of patients who receive Neoadjuvant Chemotherapy fit this profile.

Our work represents the first clinical evidence that tumor total hemoglobin estimated from DOST images differentiates women with locally advanced breast cancer who have a complete pathological response with Neoadjuvant Chemotherapy from those who do not with predictive significance based on image data acquired before the initiation of therapy. The implication of this prognostic information is that certain tumors are pre-disposed to responding to Neoadjuvant Chemotherapy, and that this predisposition should be known prior to choosing the therapy.  The study also demonstrates the potential of dramatically accelerating the validation of optimal Neoadjuvant Chemotherapy regimes through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure.

Medical Research: What should clinicians and patients take away from your report?

Dr. Jiang: Biomarkers obtained through Diffuse Optical Spectroscopic Tomographic imaging could be prognostic for response, potentially eliminating the delay in definitive local regional therapy that may occur from a complete 6-8 months course of Neoadjuvant Chemotherapy. The implication of this prognostic information is that certain tumors are pre-disposed to responding to Neoadjuvant Chemotherapy, and that this predisposition should be known prior to choosing the therapy.  The study also demonstrates the potential of dramatically accelerating the validation of optimal Neoadjuvant Chemotherapy regimes through future randomized clinical trials by reducing the number of patients required and the length of time they need to be followed by using a validated imaging surrogate as an outcome measure.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Jiang: To develop a portable and compact system to quantify more accurately changes in the breast during neoadjuvant chemotherapy. Furthermore, integrate the system into the workflow of clinical oncology practice to maximize patient participation and determine whether prognostic information can be obtained that would influence patient management.

Citation:

  1. Jiang, B. W. Pogue, P. A. Kaufman, J. Gui, M. Jermyn, T. E. Frazee, S. P. Poplack, R. DiFlorio-Alexander, W. A. Wells, K. D. Paulsen. Predicting breast tumor response to neoadjuvant chemotherapy with Diffuse Optical Spectroscopic Tomography prior to treatment. Clinical Cancer Research, 2014; DOI: 10.1158/1078-0432.CCR-14-1415