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Peer-reviewedCC BY 4.0Irish Journal of Medical Science

Relationship between overall survival and progression-free survival with 18 F-FDG PET/CT metabolic parameters in metastatic breast cancer patients treated with CDK 4/6 inhibitors

  • Ogün Bülbül1
  • Esra Aydin2
  • Demet Nak3
  1. 1Faculty of Medicine, Department of Nuclear Medicine, Erciyes University, Kayseri, 38039 Turkey
  2. 2Faculty of Medicine, Department of Medical Oncology, Recep Tayyip Erdoğan University, Rize, 53020 Turkey
  3. 3Faculty of Medicine, Department of Nuclear Medicine, Recep Tayyip Erdoğan University, Rize, 53020 Turkey
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Abstract

Background: Combining CDK 4/6 inhibitors with endocrine therapy (ET) extends progression-free survival (PFS) and overall survival (OS) in hormone receptor (HR) positive, human epidermal growth factor receptor-2 (HER2) negative metastatic breast cancer. We aimed to explore the relationship between metabolic tumor volume (MTV), total lesion glycolysis (TLG), and PFS/OS in these patients.

Methods: MTV and TLG were measured from baseline 18 F-fluorodeoxyglucose (18-FDG) positron emission tomography/computed tomography (PET/CT) of 87 HR-positive/HER2-negative metastatic breast cancer patients and their effects on survival were analyzed using Kaplan-Meier methods.

Results: The median OS was 42.0 months for patients with MTV < 121.7 cm³ and 24.6 months with ≥ 121.7 cm3 (p = 0.001). The median OS was 40.3 months for patients with TLG < 732.4 g and 24.6 months with ≥ 732.4 g (p = 0.006). The median OS for patients with an ECOG score of 0 was 53.6 months, while for those with an ECOG score of 1–2, it was 26.4 months (p = 0.005). Age ≥ 60 years (HR = 5.11, p = 0.002) and ECOG score > 0 (HR = 3.38, p = 0.011) are independent predictors of PFS.

Conclusions: Baseline 18 F-FDG PET/CT may provide prognostic insights in HR+/HER2- metastatic breast cancer. High MTV and TLG are associated with poorer OS in univariate analyses but not in multivariable analyses. ECOG score > 0 and age ≥ 60 years are independent predictors of PFS.

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Cite

BibTeXRIS
BibTeX
@article{bulbul2026relationship,
  title = {{Relationship between overall survival and progression-free survival with 18 F-FDG PET/CT metabolic parameters in metastatic breast cancer patients treated with CDK 4/6 inhibitors}},
  author = {Ogün Bülbül and Esra Aydin and Demet Nak},
  journal = {Irish Journal of Medical Science},
  year = {2026},
  month = jun,
  doi = {10.1007/s11845-026-04505-w},
  url = {https://doi.org/10.1007/s11845-026-04505-w},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Relationship between overall survival and progression-free survival with 18 F-FDG PET/CT metabolic parameters in metastatic breast cancer patients treated with CDK 4/6 inhibitors
AU  - Ogün Bülbül
AU  - Esra Aydin
AU  - Demet Nak
PY  - 2026
DA  - 2026/06/17
JO  - Irish Journal of Medical Science
DO  - 10.1007/s11845-026-04505-w
UR  - https://doi.org/10.1007/s11845-026-04505-w
AB  - Background: Combining CDK 4/6 inhibitors with endocrine therapy (ET) extends progression-free survival (PFS) and overall survival (OS) in hormone receptor (HR) positive, human epidermal growth factor receptor-2 (HER2) negative metastatic breast cancer. We aimed to explore the relationship between metabolic tumor volume (MTV), total lesion glycolysis (TLG), and PFS/OS in these patients.  Methods: MTV and TLG were measured from baseline 18 F-fluorodeoxyglucose (18-FDG) positron emission tomography/computed tomography (PET/CT) of 87 HR-positive/HER2-negative metastatic breast cancer patients and their effects on survival were analyzed using Kaplan-Meier methods.  Results: The median OS was 42.0 months for patients with MTV < 121.7 cm³ and 24.6 months with ≥ 121.7 cm3 (p = 0.001). The median OS was 40.3 months for patients with TLG < 732.4 g and 24.6 months with ≥ 732.4 g (p = 0.006). The median OS for patients with an ECOG score of 0 was 53.6 months, while for those with an ECOG score of 1–2, it was 26.4 months (p = 0.005). Age ≥ 60 years (HR = 5.11, p = 0.002) and ECOG score > 0 (HR = 3.38, p = 0.011) are independent predictors of PFS.  Conclusions: Baseline 18 F-FDG PET/CT may provide prognostic insights in HR+/HER2- metastatic breast cancer. High MTV and TLG are associated with poorer OS in univariate analyses but not in multivariable analyses. ECOG score > 0 and age ≥ 60 years are independent predictors of PFS.
SN  - 0021-1265
SN  - 1863-4362
ER  -