本研究旨在评估治疗前 [18F]FDG PET/CT 衍生生物标志物与接受抗体药物偶联物 (ADC) Sacituzumab Govitecan (SG) 和 Trastuzumab Deruxtecan (T-DXd) 治疗的转移性乳腺癌 (mBC) 患者的结局之间的关联）。对接受 SG 治疗的三阴性 mBC (mTNBC) 患者和接受 T-DXd 治疗的 HER2 低 mBC 患者进行回顾性双中心分析，这些患者在治疗前接受了 [18F]FDG PET/CT 扫描。测量了关键生物标志物，包括最大标准化摄取值（SUVmax）、总代谢肿瘤体积（TMTV）和最大肿瘤扩散（Dmax）。使用 Cox 模型和 Kaplan-Meier 曲线评估其无进展生存期 (PFS) 和总生存期 (OS) 的预后价值。纳入了 128 名患者：71 名接受 SG 治疗的 mTNBC，57 名 HR 阳性和阴性 HER2-low mBC用 T-DXd 治疗。中位随访时间为 12.9 个月。在 SG 队列中，中位 PFS 和 OS 分别为 4.8 个月和 8.9 个月。高 Dmax（HR 2.1，95% CI 1.1-4.3）和高 TMTV（HR 2.9，95% CI 1.2-6.6）与较短的 OS 独立相关。在 T-DXd 队列中，中位 PFS 和 OS 分别为 5.8 个月和 9.0 个月。高 Dmax（HR 2.1，95% CI 1.2-3.9）和高 TMTV（HR 2.4，95% CI 1.0-6.5）分别与较短的 PFS 和较短的 OS 独立相关。预处理 [18F]FDG PET/CT 衍生的生物标志物，即 TMTV 和 Dmax，对于接受 SG 和 T-DXd 治疗的 mTNBC 和 HER2 低 mBC 患者具有显着的预后价值。这些生物标志物可以改善预后预测，并可能优化治疗策略，保证其临床使用，但需要更大规模的研究来验证这些发现。© 2024。作者获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

This study aimed to evaluate the association between pretreatment [18F]FDG PET/CT-derived biomarkers and outcomes in metastatic breast cancer (mBC) patients treated with antibody-drug conjugates (ADCs) Sacituzumab Govitecan (SG) and Trastuzumab Deruxtecan (T-DXd).A retrospective bicentric analysis was conducted on triple-negative mBC (mTNBC) patients treated with SG and HER2-low mBC patients treated with T-DXd, who underwent [18F]FDG PET/CT scans before therapy. Key biomarkers, including maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV) and maximum tumor dissemination (Dmax), were measured. Their prognostic value for progression-free survival (PFS) and overall survival (OS) was assessed using Cox models and Kaplan-Meier curves.128 patients were included: 71 mTNBC treated with SG and 57 HR-positive and -negative HER2-low mBC treated with T-DXd. Median follow-up was 12.9 months. In the SG cohort, median PFS and OS were 4.8 and 8.9 months, respectively. High Dmax (HR 2.1, 95% CI 1.1-4.3) and high TMTV (HR 2.9, 95% CI 1.2-6.6) were independently associated with shorter OS. In the T-DXd cohort, median PFS and OS were 5.8 and 9.0 months, respectively. High Dmax (HR 2.1, 95% CI 1.2-3.9) and high TMTV (HR 2.4, 95% CI 1.0-6.5) independently correlated with shorter PFS and shorter OS, respectively.Pretreatment [18F]FDG PET/CT-derived biomarkers, namely TMTV and Dmax, have significant prognostic value in patients with mTNBC and HER2-low mBC treated with SG and T-DXd. These biomarkers improve prognostic prediction and may optimize treatment strategies, warranting their clinical use, but larger studies are needed to validate these findings.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.