Interim positron emission tomography during frontline chemoimmunotherapy for follicular lymphoma Journal Article
| Authors: | Merryman, R. W.; Michaud, L.; Redd, R.; Mondello, P.; Park, H.; Spilberg, G.; Robertson, M.; Taranto, E.; Ahmed, G.; Chase, M.; Jeter, E.; Ahn, I. E.; Brown, J. R.; Crombie, J.; Davids, M. S.; Fisher, D. C.; Jacobsen, E.; Jacobson, C. A.; Kim, A. I.; LaCasce, A. S.; Ng, S. Y.; Odejide, O. O.; Parry, E. M.; Salles, G.; Zelenetz, A. D.; Armand, P.; Schöder, H.; Jacene, H. |
| Article Title: | Interim positron emission tomography during frontline chemoimmunotherapy for follicular lymphoma |
| Abstract: | While most patients with follicular lymphoma (FL) have excellent outcomes with frontline chemoimmunotherapy (CIT), a subset of patients will experience early progression, which is associated with poor subsequent outcomes. Novel biomarkers are needed to identify high-risk patients earlier. We hypothesized that interim positron emission tomography (PET) would predict progression-free survival (PFS) in this population. We retrospectively identified 128 patients with grade 1-3A FL who had an interim PET after 2-4 cycles of frontline CIT at 2 academic centers. PET scans were analyzed using Deauville score (DS) and change in maximum standardized uptake value (ΔSUVmax). Interim PET DS was a significant predictor of PFS (P < 0.003). Patients with a DS of 3 had outcomes similar to those of patients with a DS of 4, so were categorized as PET-positive for additional analyses. Interim PET remained a strong predictor of PFS (DS 3-5, hazard ratio [HR] 2.4, P = 0.006) in a multivariable analysis and was also an early predictor of both a positive end-of-treatment PET (P < 0.001) and progression of disease within 24 months (POD24) (P = 0.006). An optimal ΔSUVmax cutoff of 75% was selected using the bootstrap method. ΔSUVmax <75% was also a significant predictor of PFS on univariable and multivariable analyses (HR 2.8, P < 0.003). In a separate cohort of 50 patients with high-grade FL, interim PET interpreted using either DS (P < 0.001) or ΔSUVmax75% (P = 0.034) was also a significant predictor of inferior PFS. In conclusion, interim PET is an independent predictor of PFS and may be useful as a tool for response-adapted treatment strategies in FL. © 2023 Wolters Kluwer Health. All rights reserved. |
| Keywords: | adult; cancer survival; controlled study; major clinical study; systemic therapy; cancer patient; rituximab; outcome assessment; positron emission tomography; progression free survival; cohort analysis; retrospective study; multicenter study; follicular lymphoma; cytopenia; infectious complication; bootstrapping; maximum standardized uptake value; human; male; female; article; cyclophosphamide plus doxorubicin plus prednisolone plus rituximab plus vincristine |
| Journal Title: | HemaSphere |
| Volume: | 7 |
| Issue: | 2 |
| ISSN: | 2572-9241 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2023-02-01 |
| Start Page: | e826 |
| Language: | English |
| DOI: | 10.1097/hs9.0000000000000826 |
| PROVIDER: | scopus |
| PMCID: | PMC9875968 |
| PUBMED: | 36713355 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2023 -- Source: Scopus |
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