PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts.

Autor: Desai SH; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Pederson L; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., LaPlant B; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Mwangi R; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Maurer M; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Young JR; Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Jacksonville, FL, USA., Macon WR; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., King RL; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Wang Y; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Cerhan JR; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Feldman A; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA., Inwards DJ; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Micallef I; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Johnston P; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Porrata LF; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Ansell SM; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Habermann TM; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Witzig TE; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA., Nowakowski GS; Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. Nowakowski.Grzegorz@mayo.edu.
Jazyk: angličtina
Zdroj: Blood cancer journal [Blood Cancer J] 2022 May 03; Vol. 12 (5), pp. 78. Date of Electronic Publication: 2022 May 03.
DOI: 10.1038/s41408-022-00649-x
Abstrakt: Studies evaluating Positron Emission Tomography scan after 2 cycles of chemotherapy (PET2) in newly diagnosed diffuse large B cell lymphoma (DLBCL) are heterogeneous in patient characteristics, treatments and have conflicting results. Here we report association of PET2 with outcomes in two large independent prospective cohorts of newly diagnosed DLBCL pts treated with two RCHOP-based regimens. The discovery cohort consisted of pts enrolled in single arm phase 2 MC078E study of lenalidomide with RCHOP (R2CHOP). The validation cohort consisted of RCHOP-treated pts from the Molecular Epidemiology Resource (MER) cohort. Pts who received 3-6 cycles of therapy and had PET2 were included in the study. Patients who progressed on PET2 were excluded. Revised response criteria 2007 were used to define PET2 response PET2 positive (PET2 + ) pts had inferior EFS [24-month EFS 45.5% vs 87.9%, HR 4.0, CI 95 (2.1-7.9), p < 0.0001) with a trend towards lower OS [24-months OS 77% vs 94.8%, HR 2.0, CI 95 (0.9-4.8), P = 0.1] than PET2 negative (PET2-) pts in MC078E cohort. PET2 + pts had an inferior EFS (24 month EFS 48.7% vs 81.6%, HR 2.9, CI 95 2.0-4.2, p < 0.0001) and OS (24-month OS 68.6% vs 88.1%, HR 2.3, CI 95 : 1.5-3.5, p < 0.0001) in the MER cohort. These results were consistent regardless of age, sex and in the subgroup of advanced stage and high-risk international prognostic index (IPI). For MER, PET2 + pts also had higher odds of positive end of treatment PET (OR: 17.3 (CI 95 7.9-37.7), p < 0.001). PET2 is an early predictor DLBCL pts at high risk of progression and death in two independent prospective cohorts. PET2-guided risk-adapted strategies may improve outcomes, and should be explored in clinical trials.
(© 2022. The Author(s).)
Databáze: MEDLINE
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