Prognostic value of baseline FDG PET/CT in HER2-positive metastatic breast cancer treated with first-line trastuzumab, pertuzumab, and docetaxel

Abstract

Trastuzumab, pertuzumab, and docetaxel (THP) have represented the standard first-line treatment for HER2-positive metastatic breast cancer (MBC) for over a decade, following the pivotal CLEOPATRA trial. However, interim results from the DESTINY-Breast09 trial suggest that trastuzumab deruxtecan (T-DXd) may soon replace THP as the new first-line standard. Recent developments in treatment have raised new questions about how best to match therapy intensity with individual patient profiles. FDG PET/CT, routinely used for metabolic imaging, might help by identifying patients with differing prognoses based on baseline tumor activity. We investigated the prognostic relevance of baseline FDG PET/CT and its association with treatment outcomes in HER2-positive MBC patients receiving first-line THP.