Abstract #4007

Early treatment re-direction based on functional tumor volume at 3 and 6-week MRI for breast cancer patients undergoing neoadjuvant chemotherapy

Natsuko Onishi¹, Jessica Gibbs¹, Wen Li¹, David C. Newitt¹, Elissa R. Price¹, Barbara LeStage², William F. Symmans³, Angela DeMichele⁴, Christina Yau⁵, The I-SPY 2 Imaging Working Group⁶, The I-SPY 2 Consortium⁶, Laura J. Esserman⁵, and Nola M. Hylton¹

¹Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²I-SPY 2 Advocacy Group, San Francisco, CA, United States, ³MD Anderson Cancer Center, Houston, TX, United States, ⁴University of Pennsylvania, Philadelphia, PA, United States, ⁵Department of Surgery, University of California, San Francisco, San Francisco, CA, United States, ⁶Quantum Leap Healthcare Collaborative, San Francisco, CA, United States

Synopsis

In the I-SPY2 breast cancer trial, functional tumor volume (FTV) derived from dynamic contrast-enhanced MRI is used as a longitudinal measure of response to adjust patient randomization and evaluate drug efficacy. I-SPY2 is introducing a treatment “escalation” option, giving patients the opportunity to re-direct to potentially more effective treatment based on early indication of inferior response by MRI. We retrospectively investigated the ability of FTV reduction to predict inferior outcome. Combined criteria using FTV reduction at 3 and 6 weeks of treatment showed high PPV and high sensitivity in early detection of non-responders.

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