Document Type

Article

Publication Date

10-19-2018

Publication Title

Journal of Biomedical Optics

Department

Thayer School of Engineering

Abstract

Ideally, neoadjuvant chemotherapy (NAC) assessment should predict pathologic complete response (pCR), a surrogate clinical endpoint for 5-year survival, as early as possible during typical 3- to 6-month breast cancer treatments. We introduce and demonstrate an approach for predicting pCR within 10 days of initiating NAC. The method uses a bedside diffuse optical spectroscopic imaging (DOSI) technology and logistic regression modeling. Tumor and normal tissue physiological properties were measured longitudinally throughout the course of NAC in 33 patients enrolled in the American College of Radiology Imaging Network multicenter breast cancer DOSI trial (ACRIN-6691). An image analysis scheme, employing z-score normalization to healthy tissue, produced models with robust predictions. Notably, logistic regression based on z-score normalization using only tissue oxygen saturation (StO2) measured within 10 days of the initial therapy dose was found to be a significant predictor of pCR (AUC  =  0.92; 95% CI: 0.82 to 1). This observation suggests that patients who show rapid convergence of tumor tissue StO2 to surrounding tissue StO2 are more likely to achieve pCR. This early predictor of pCR occurs prior to reductions in tumor size and could enable dynamic feedback for optimization of chemotherapy strategies in breast cancer.

DOI

10.1117/1.JBO.24.2.021202

Original Citation

Cochran JM, Busch DR, Leproux A, Zhang Z, O'Sullivan TD, Cerussi AE, Carpenter PM, Mehta RS, Roblyer D, Yang W, Paulsen KD, Pogue B, Jiang S, Kaufman PA, Chung SH, Schnall M, Snyder BS, Hylton N, Carp SA, Isakoff SJ, Mankoff D, Tromberg BJ, Yodh AG. Tissue oxygen saturation predicts response to breast cancer neoadjuvant chemotherapy within 10 days of treatment. J Biomed Opt. 2018 Oct;24(2):1-11. doi: 10.1117/1.JBO.24.2.021202. PMID: 30338678; PMCID: PMC6194199.

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