Worsening bone scan in the evaluation of antitumor response during hormonal therapy of XXXX .

@entity1 @entity79 @entity5 @entity0
PURPOSE: Scintigraphic flare in association with response to therapy has been well described in the medical literature. During the course of a recent @entity0 trial, it became apparent that several @entity1 with worsening bone scan but no other clinical evidence of disease progression might have potentially benefited from continued therapy, but had therapy discontinued. A retrospective analysis of this issue was performed to assess the magnitude and scope of this problem. MATERIALS AND METHODS: A total of 648 @entity1 with hormone receptor-positive or unknown @entity0 were treated as part of a large-scale trial of first-line hormonal therapy. @entity1 were assessed for response to therapy, including response duration, progression-free interval (PFI), overall survival, and quality of life. The retrospective analysis presented here was performed to assess whether @entity1 with a possible scintigraphic flare within the first 16 weeks of therapy might have had therapy discontinued prematurely due to a worsening bone scan attributable to @entity5 flare, rather than due to disease progression. RESULTS: Analysis of the hormonal trial showed that of 376 assessable @entity1 108 (29%) with @entity79 had a possible scintigraphic flare by week 8 or 16 of the trial, based on data on the case report forms and radiology reports (bone scans and x-rays). Of these, 69 @entity1 (64%) were continued on study therapy, which resulted in clinical benefit in 50 (72%) of those @entity1 . In contrast, 39 @entity1 (36%) with possible scintigraphic flare were removed from the trial. CONCLUSION: We conclude that changes in bone scintigraphy that mimic progressive disease early in the course of hormonal treatment of @entity1 with @entity0 metastatic to bone may represent scintigraphic flare associated with response. Thus, clinicians must be cognizant of the phenomenon of scintigraphic flare to avoid premature discontinuation of a potentially beneficial treatment.
