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Prognostic models integrating quantitative parameters from baseline and interim positron emission computed tomography in patients with diffuse large B-cell lymphoma: post-hoc analysis from the SAKK38/07 clinical trial.
Journal article

Prognostic models integrating quantitative parameters from baseline and interim positron emission computed tomography in patients with diffuse large B-cell lymphoma: post-hoc analysis from the SAKK38/07 clinical trial.

  • Zucca E Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
  • Cascione L Institute of Oncology Research, Università della Svizzera italiana, Bellinzona, Switzerland.
  • Ruberto T Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland.
  • Facchinelli D Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
  • Schär S Coordinating Center, SAKK-Swiss Group for Clinical Cancer Research, Bern, Switzerland.
  • Hayoz S Coordinating Center, SAKK-Swiss Group for Clinical Cancer Research, Bern, Switzerland.
  • Dirnhofer S Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland.
  • Giovanella L Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland.
  • Bargetzi M Oncology Center, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Mamot C Oncology Center, Cantonal Hospital Aarau, Aarau, Switzerland.
  • Ceriani L Institute of Oncology Research, Università della Svizzera italiana, Bellinzona, Switzerland.
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  • 2020-09-18
Published in:
  • Hematological oncology. - 2020
diffuse large B-cell lymphoma
international prognostic index
positron-emission computed tomography
prognostic models
English Positron emission computed tomography (PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) enrolled in a prospective clinical trial were reviewed to test the impact of quantitative parameters from interim PET/CT scans on overall (OS) and progression-free (PFS) survival. We centrally reviewed baseline and interim PET/CT scans of 138 patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone given every 14 days (R-CHOP14) in the SAKK38/07 trial (ClinicalTrial.gov identifier: NCT00544219). Cutoff values for maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and metabolic heterogeneity (MH) were defined by receiver operating characteristic analysis. Responses were scored using the Deauville scale (DS). Patients with DS 5 at interim PET/CT (defined by uptake >2 times higher than in normal liver) had worse PFS (P = 0.014) and OS (P < 0.0001). A SUVmax reduction (Δ) greater than 66% was associated with longer PFS (P = 0.0027) and OS (P < 0.0001). Elevated SUVmax , MTV, TLG, and MH at interim PET/CT also identified patients with poorer outcome. At multivariable analysis, ΔSUVmax and baseline MTV appeared independent outcome predictors. A prognostic model integrating ΔSUVmax and baseline MTV discriminated three risk groups with significantly (log-rank test for trend, P < 0.0001) different PFS and OS. Moreover, the integration of MH and clinical prognostic indices could further refine the prediction of OS. PET metrics-derived prognostic models perform better than the international indices alone. Integration of baseline and interim PET metrics identified poor-risk DLBCL patients who might benefit from alternative treatments.
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  • English
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https://sonar.ch/global/documents/139573
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