为了确定预处理的[18F]FDG PET/CT是否可以预测早期三阴性乳腺癌（TNBC）患者在新辅助化疗中是否能达到完全病理学完全缓解（pCR）。在这项回顾性的双中心研究中，我们纳入了2017年3月至2022年8月接受新辅助化疗（NAC）或化疗免疫疗法（NACI）前进行[18F]FDG PET/CT检查的TNBC患者。收集了临床、生物学和病理学数据。从PET图像中测量了肿瘤SUVmax和总代谢肿瘤体积（TMTV）。通过ROC曲线确定了截断值，并使用逻辑回归建立了多变量模型来预测pCR。共纳入了191例患者。在接受NAC（N = 91）和NACI（N = 100）治疗的患者中，pCR率分别为53%和70%（p < 0.01）。单变量分析显示，NAC组中的高Ki67、高肿瘤SUVmax（> 12.3）和低TMTV（≤ 3.0 cm3）是pCR的预测因子，而NACI组中的肿瘤分期分类（ 17.2）和低TMTV（≤ 7.3 cm3）与pCR相关。多变量分析只发现高肿瘤SUVmax（NAC：OR 8.8，p < 0.01；NACI：OR 3.7，p = 0.02）和低TMTV（NAC：OR 6.6，p < 0.01；NACI：OR 3.5，p = 0.03）是两组中独立的pCR因子，尽管阈值不同。在NAC中，高肿瘤代谢和低肿瘤负担能够无论是否加用pembrolizumab都预测pCR。需要进一步的研究来验证这些发现，并确定如何利用这些生物标志物指导TNBC患者的新辅助治疗。© 2023. 作者（由Springer Nature的Springer-Verlag GmbH德国部分独家许可）

To determine if pretreatment [18F]FDG PET/CT could contribute to predicting complete pathological complete response (pCR) in patients with early-stage triple-negative breast cancer (TNBC) undergoing neoadjuvant chemotherapy with or without pembrolizumab.In this retrospective bicentric study, we included TNBC patients who underwent [18F]FDG PET/CT before neoadjuvant chemotherapy (NAC) or chemo-immunotherapy (NACI) between March 2017 and August 2022. Clinical, biological, and pathological data were collected. Tumor SUVmax and total metabolic tumor volume (TMTV) were measured from the PET images. Cut-off values were determined using ROC curves and a multivariable model was developed using logistic regression to predict pCR.N = 191 patients were included. pCR rates were 53 and 70% in patients treated with NAC (N = 91) and NACI (N = 100), respectively (p < 0.01). In univariable analysis, high Ki67, high tumor SUVmax (> 12.3), and low TMTV (≤ 3.0 cm3) were predictors of pCR in the NAC cohort while tumor staging classification (< T3), BRCA1/2 germline mutation, high tumor SUVmax (> 17.2), and low TMTV (≤ 7.3 cm3) correlated with pCR in the NACI cohort. In multivariable analysis, only high tumor SUVmax (NAC: OR 8.8, p < 0.01; NACI: OR 3.7, p = 0.02) and low TMTV (NAC: OR 6.6, p < 0.01; NACI: OR 3.5, p = 0.03) were independent factors for pCR in both cohorts, albeit at different thresholds.High tumor metabolism (SUVmax) and low tumor burden (TMTV) could predict pCR after NAC regardless of the addition of pembrolizumab. Further studies are warranted to validate such findings and determine how these biomarkers could be used to guide neoadjuvant therapy in TNBC patients.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.