What is a FES PET CT for ER+ breast cancer?
18F-Fluoroestradiol (FES) PET scanning has emerged as a revolutionary tool in the diagnosis and management of certain types of breast cancer. The remarkable story of FES PET began in the early 1980s when researchers developed 16α-[18F]fluoroestradiol (FES), the first PET imaging agent for visualizing estrogen receptors (ER) in breast cancer tumors. This innovation allowed doctors to non-invasively visualize ER-positive tumors, predict hormone therapy responses, and potentially avoid unnecessary surgeries.
The journey from concept to clinical application for FES PET, like many oncology innovations, has been a long and meticulous process. In oncology research and care, the path from initial concept to FDA approval typically spans 10 to 15 years, sometimes even longer. This extended timeline reflects the rigorous testing required to ensure both efficacy and safety in cancer diagnostics and treatments.
For FES PET, the process began with its initial development in the early 1980s (as mentioned above) followed by years of preclinical studies and early clinical investigations. The first human studies with FES PET were conducted in the late 1980s and early 1990s, marking the transition from laboratory to clinical research.
In recent years, several pivotal clinical trials have played a crucial role in proving the efficacy and safety of FES PET scans. For instance, a Phase II trial studied the use of FES PET/CT in predicting response to endocrine therapy in patients with newly diagnosed metastatic breast cancer. The trial aimed to monitor changes in ER expression and predict prognosis based on FES uptake, validating its utility in clinical settings.
The FDA approval of FES PET (specifically, GE Healthcare’s Cerianna) came in May 2020, nearly four decades after its initial development. This timeline underscores the extensive research, testing, and regulatory processes involved in bringing a new diagnostic tool from concept to clinical use in oncology.
Today, FES PET is recommended by the National Comprehensive Cancer Network (NCCN) Guidelines for specific scenarios in breast cancer management. It’s particularly useful for patients with recurrent or metastatic breast cancer, especially when standard imaging is inconclusive or biopsy is challenging.
“FES PET, like FDG PET, is now included in the NCCN Guidelines®. We have an opportunity to use FES PET to assess ER function in all tumor sites in patients with ER+ metastatic breast cancer. This is a helpful tool for diagnostic confirmation and may have the ability to aid in prognosis and prediction of clinical benefit from endocrine-based therapies, including with CDK 4/6 inhibitors.” – Dr. Hannah M Linden, Breast Medical Oncologist at the University of Washington and Fred Hutchinson Cancer Center
As we look to the future of breast cancer diagnosis and treatment, FES PET scanning stands out as a promising technology. While its availability is currently limited, the recent inclusion of FES PET in the NCCN Guidelines® marks a significant milestone.
This recognition is likely to accelerate its adoption across major cancer centers in the United States. Patients interested in FES PET scans should consult with their oncologists or reach out to major cancer centers in their area to inquire about availability. As more healthcare providers recognize the value of this innovative tool, we can expect to see FES PET scans offered at an increasing number of cancer centers in the coming years. This expansion will undoubtedly contribute to more personalized and effective breast cancer care, offering hope and improved outcomes for patients facing this challenging diagnosis.
Remember, every patient’s journey is unique, and FES PET is just one of many tools that can help guide your care. Always work closely with your healthcare team to determine the best approach for your individual needs.
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