Initial Clinical Results of a Novel Immuno-PET Theranostic Probe in Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer.

This prospective study evaluated the imaging performance of a novel pretargeting immunologic PET (immuno-PET) method in patients with human epidermal growth factor receptor 2 (HER2)-negative, carcinoembryonic antigen (CEA)-positive metastatic breast cancer, compared with CT, bone MRI, and F-FDG PET. Twenty-three patients underwent whole-body immuno-PET after injection of 150 MBq of Ga-IMP288, a histamine-succinyl-glycine peptide given after initial targeting of a trivalent anti-CEA, bispecific, antipeptide antibody. The gold standards were histology and imaging follow-up. Tumor SUVs (SUV and SUV) were measured, and tumor burden was analyzed using total tumor volume and total lesion activity. The total lesion sensitivity of immuno-PET and F-FDG PET were 94.7% (1,116/1,178) and 89.6% (1,056/1,178), respectively. Immuno-PET had a somewhat higher sensitivity than CT or F-FDG PET in lymph nodes (92.4% vs. 69.7% and 89.4%, respectively) and liver metastases (97.3% vs. 92.1% and 94.8%, respectively), whereas sensitivity was lower for lung metastases (48.3% vs. 100% and 75.9%, respectively). Immuno-PET showed higher sensitivity than MRI or F-FDG PET for bone lesions (95.8% vs. 90.7% and 89.3%, respectively). In contrast to F-FDG PET, immuno-PET disclosed brain metastases. Despite equivalent tumor SUV, SUV and total tumor volume, total lesion activity was significantly higher with immuno-PET than with F-FDG PET ( = 0.009). Immuno-PET using anti-CEA/anti-IMP288 bispecific antibody, followed by Ga-IMP288, is a potentially sensitive theranostic imaging method for HER2-negative, CEA-positive metastatic breast cancer patients and warrants further research.