64Cu-DOTA-Trastuzumab PET Imaging in Patients with HER2-Positive Breast Cancer

• DOI: 10.2967/jnumed.112.118612
• Publication Date: 2013-09-13T02:47:50Z
• Authors: Kenji Tamura; Hiroaki Kurihara; Kan Yonemori; Hitoshi Tsuda; Junko Suzuki; Yuzuru Kono; Natsuki Honda; Makoto Kodaira; Harukaze Yamamoto; Mayu Yunokawa; Chikako Shimizu; Koki Hasegawa; Yousuke Kanayama; Satoshi Nozaki; Takayuki Kinoshita; Yasuhiro Wada; Shusaku Tazawa; Kazuhiro Takahashi; Yasuyoshi Watanabe; Yasuhiro Fujiwara
• Keywords: Adult; 0301 basic medicine; Receptor, ErbB-2; Breast Neoplasms; Middle Aged; Trastuzumab; Antibodies, Monoclonal, Humanized; 3. Good health; 03 medical and health sciences; Positron-Emission Tomography; Image Processing, Computer-Assisted; Organometallic Compounds; Feasibility Studies; Humans; Neoplasm Metastasis; Safety; Aged

The purpose of this study was to determine the safety, distribution, internal dosimetry, and initial human epidermal growth factor receptor 2 (HER2)-positive tumor images of (64)Cu-DOTA-trastuzumab in humans.PET was performed on 6 patients with primary or metastatic HER2-positive breast cancer at 1, 24, and 48 h after injection of approximately 130 MBq of the probe (64)Cu-DOTA-trastuzumab. Radioactivity data were collected from the blood, urine, and normal-tissue samples of these 6 patients, and the multiorgan biodistribution and internal dosimetry of the probe were evaluated. Safety data were collected for all the patients after the administration of (64)Cu-DOTA-trastuzumab and during the 1-wk follow-up period.According to our results, the best timing for the assessment of (64)Cu-DOTA-trastuzumab uptake by the tumor was 48 h after injection. Radiation exposure during (64)Cu-DOTA-trastuzumab PET was equivalent to that during conventional (18)F-FDG PET. The radioactivity in the blood was high, but uptake of (64)Cu-DOTA-trastuzumab in normal tissues was low. In 2 patients, (64)Cu-DOTA-trastuzumab PET showed brain metastases, indicative of blood-brain barrier disruptions. In 3 patients, (64)Cu-DOTA-trastuzumab PET imaging also revealed primary breast tumors at the lesion sites initially identified by CT.The findings of this study indicated that (64)Cu-DOTA-trastuzumab PET is feasible for the identification of HER2-positive lesions in patients with primary and metastatic breast cancer. The dosimetry and pharmacologic safety results were acceptable at the dose required for adequate PET imaging.