Early positron emission tomography/computed tomography as a predictor of response after CTL019 chimeric antigen receptor – T-cell therapy in B-cell non-Hodgkin lymphomas Journal Article


Authors: Shah, N. N.; Nagle, S. J.; Torigian, D. A.; Farwell, M. D.; Hwang, W. T.; Frey, N.; Nasta, S. D.; Landsburg, D.; Mato, A.; June, C. H.; Schuster, S. J.; Porter, D. L.; Svoboda, J.
Article Title: Early positron emission tomography/computed tomography as a predictor of response after CTL019 chimeric antigen receptor – T-cell therapy in B-cell non-Hodgkin lymphomas
Abstract: Molecular imaging with 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is an established modality for response assessment in patients with lymphoma undergoing treatment. However, patients treated with novel immunotherapies may have false-positive PET/CT findings due to tumor site and systemic inflammation. In particular, treatment with autologous chimeric antigen receptor modified T-cells redirected at CD19 (CTL019 CAR-T cells) is often complicated by “cytokine release syndrome” (CRS) due to a severe systemic inflammatory reaction. Infiltration of tumors by activated CTL019 cells may impact radiographic and functional imaging findings. The role of PET/CT in patients treated with CTL019 has not previously been described. We performed a pilot, single-arm, prospective study to explore the utility of early PET/CT in patients with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) undergoing treatment with CTL019 CAR-T cells. Patients had PET/CT prior to CTL019 infusion and then early PET/CT at 1 month after treatment. The primary outcome was the amount/change in metabolically active tumor volume (MTV) and FDG uptake. We enrolled seven patients (DLBCL, three; FL, four). Six of 7 had baseline PET/CT with active disease. On post-treatment PET/CT, three patients had no residual MTV, two patients had a decrease in MTV and two patients had an increase in MTV. The three patients with no residual MTV all remain in remission >2 years post-treatment. The patients with less than complete response all subsequently relapsed. Development of CRS did not confound PET/CT findings. In patients with DLBCL and FL receiving CTL019 CAR-T cells, early PET/CT may predict response to this novel immunotherapy. © 2018 Elsevier Ltd
Keywords: immunotherapy; lymphoma; response assessment; 18f-fluorodeoxyglucose positron emission tomography/computed tomography
Journal Title: Cytotherapy
Volume: 20
Issue: 12
ISSN: 1465-3249
Publisher: Elsevier Science Ltd.  
Date Published: 2018-12-01
Start Page: 1415
End Page: 1418
Language: English
DOI: 10.1016/j.jcyt.2018.10.003
PROVIDER: scopus
PUBMED: 30385043
DOI/URL:
Notes: Cytotherapy -- Export Date: 2 January 2019 -- Letter -- CODEN: CYTRF -- Source: Scopus
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MSK Authors
  1. Anthony R Mato
    34 Mato