A groundbreaking clinical trial is underway in New Zealand, seeking to establish a new "gold standard" for staging lobular breast cancer. This innovative approach utilizes PET-CT imaging with a newly discovered radioactive tracer, Fibroblast Activation Protein Inhibitor (FAPI), offering the potential for more accurate disease assessment and tailored treatment strategies.
Addressing the Challenges of Lobular Breast Cancer
Lobular breast cancer, the second most common type of breast cancer, affects approximately 450 women in New Zealand annually. Unlike other forms of breast cancer that typically present as a lump, lobular breast cancer cells grow in single layers, making them more difficult to detect via mammography. This unique growth pattern poses challenges in accurately determining the stage and grade of tumors, leading to potential issues in treatment planning.
Without precise knowledge of the cancer's extent, patients with lobular breast cancer face a higher risk of either receiving unnecessarily aggressive treatment or insufficient treatment, increasing the likelihood of cancer recurrence or spread. This highlights the urgent need for improved staging methods to optimize treatment outcomes.
FAPI-PET-CT: A Novel Imaging Approach
Dr. Remy Lim, medical director of Mercy Radiology and lead investigator of the trial, explains the innovative approach: "We've designed a completely new approach to imaging lobular breast cancer using PET-CT with a newly discovered radioactive tracer called Fibroblast Activation Protein Inhibitor, or FAPI." The FAPI tracer binds to cancerous cells, allowing for a more precise visualization of the cancer's size and any potential spread within the breast and beyond.
The trial will involve 50 lobular breast cancer patients recruited from public hospitals across New Zealand. Participants will undergo a PET-CT scan using the FAPI tracer. The clinical team will then assess whether the FAPI-PET-CT imaging reveals areas of cancer that were not detected by previous imaging methods. If discrepancies are found, the team will re-evaluate the patient's initial staging and adjust the treatment pathway accordingly.
Potential Impact on Treatment and Access
The potential benefits of this improved staging method are significant. By providing a more accurate assessment of the disease's extent, FAPI-PET-CT could help prevent the overtreatment of some patients, sparing them from unnecessary side effects and improving their quality of life. Conversely, it could also identify patients who require more aggressive treatment to effectively combat the cancer.
Currently, PET-CT scans are primarily available to individuals receiving private treatment in New Zealand. The Breast Cancer Foundation NZ hopes that the results of this trial will advocate for the funding of PET-CT for lobular breast cancer patients within the public health system, ensuring equitable access to the best standard of care for all New Zealanders.
Ah-Leen Rayner, chief executive of Breast Cancer Foundation NZ, emphasizes the importance of this research: "By funding this research partnership, we're hoping the results will make the case for PET-CT becoming funded for lobular breast cancer patients being treated in the public health system because currently, only women receiving private treatment can access it outside of this trial."
