Abstract #0411

Prospective performance of an MRI algorithm for early re-direction of breast cancer neoadjuvant treatment

Natsuko Onishi¹, Jesiica E Gibbs¹, Wen Li¹, Elissa R Price ¹, Barbara LeStage², William F Symmans³, Christina Yau⁴, John Kornak⁵, the I-SPY 2 Imaging Working Group, the I-SPY 2 Investigator Network⁶, Angela DeMichele⁷, Laura J Esserman⁴, 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, ³Department of Pathology, MD Anderson Cancer Center, Houston, TX, United States, ⁴Department of Surgery, University of California, San Francisco, San Francisco, CA, United States, ⁵Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States, ⁶University of California, San Francisco, San Francisco, CA, United States, ⁷Department of Medical Oncology, University of Pennsylvania, Philadelphia, PA, United States

Synopsis

Keywords: Breast, Cancer

Motivation: In our preliminary study of breast cancer patients undergoing neoadjuvant treatment in the I-SPY 2 TRIAL, functional tumor volume (FTV)-based algorithm using 3-week and 6-week MRI successfully identified sub-optimal responders as potential candidates for early treatment re-direction.

Goal(s): We aimed to evaluate the performance of the algorithm using data collected after the requirement for 6-week MRI based on 3-week response was officially added.

Approach: We tested PPV and sensitivity of the algorithm in 146 patients enrolled in I-SPY 2 between October 2021 and June 2022.

Results: The combined 3-week and 6-week MRI algorithm showed high PPV and high sensitivity in identifying sub-optimal responders.

Impact: In the I-SPY 2 neoadjuvant breast cancer trial, an MRI-based algorithm demonstrated its ability to identify sub-optimal responders at 6 weeks of treatment. This will impact response-based personalization of treatment in future clinical trials and ultimately treatment in the clinic.

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