Interim FDG-PET improves treatment failure prediction in primary central nervous system lymphoma: An LOC network prospective multicentric study.

Autor:	Rozenblum L; Department of Nuclear Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.; INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France., Houillier C; Department of Neurology 2 Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Inserm, CNRS, Institut du Cerveau, Sorbonne Université, Paris, France., Baptiste A; Department of Public Health, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Sorbonne Université, Paris, France., Soussain C; Department of Haematology, Institut Curie, Site Saint-Cloud and INSERM U932 Institut Curie, Université PSL, Paris, France., Edeline V; Department of Nuclear Medicine, Institut Curie, St-Cloud, France., Naggara P; Department of Nuclear Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France., Soret M; Department of Nuclear Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France., Causse-Lemercier V; Department of Nuclear Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France., Willems L; Department of Haematology, Cochin Hospital, AP-HP, Paris., Choquet S; Department of Haematology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France., Ursu R; Department of Neurology, AP-HP, Hôpital Saint-Louis, Paris, France., Galanaud D; Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France., Belin L; Department of Public Health, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Sorbonne Université, Paris, France., Hoang-Xuan K; Department of Neurology 2 Mazarin, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Inserm, CNRS, Institut du Cerveau, Sorbonne Université, Paris, France., Kas A; Department of Nuclear Medicine, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France.; INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, Sorbonne Université, Paris, France.
Jazyk:	angličtina
Zdroj:	Neuro-oncology [Neuro Oncol] 2024 Jul 05; Vol. 26 (7), pp. 1292-1301.
DOI:	10.1093/neuonc/noae029
Abstrakt:	Background: The purpose of our study was to assess the predictive and prognostic role of 2-18F-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/MRI during high-dose methotrexate-based chemotherapy (HD-MBC) in de novo primary central nervous system lymphoma (PCNSL) patients aged 60 and above. Methods: This prospective multicentric ancillary study included 65 immunocompetent patients who received induction HD-MBC as part of the BLOCAGE01 phase III trial. FDG-PET/MRI were acquired at baseline, post 2 cycles (PET/MRI2), and posttreatment (PET/MRI3). FDG-PET response was dichotomized with "positive" indicating persistent tumor uptake higher than the contralateral mirroring brain region. Performances of FDG-PET and International PCNSL Collaborative Group criteria in predicting induction response, progression-free survival (PFS), and overall survival (OS) were compared. Results: Of the 48 PET2 scans performed, 9 were positive and aligned with a partial response (PR) on MRI2. Among these, 8 (89%) progressed by the end of the induction phase. In contrast, 35/39 (90%) of PET2-negative patients achieved complete response (CR). Among the 18 discordant responses at interim (PETCR/MRIPR), 83% ultimately achieved CR. Eighty-seven percent of the PET2-negative patients were disease free at 6 months versus 11% of the PET2-positive patients (P < .001). The MRI2 response did not significantly differentiate patients based on their PFS, regardless of whether they were in CR or PR. Both PET2 and MRI2 independently predicted OS in multivariate analysis, with PET2 showing a stronger association. Conclusions: Our study highlights the potential of interim FDG-PET for early management of PCNSL patients. Response-driven treatment based on PET2 may guide future clinical trials. Trial: LOCALYZE, NCT03582254, ancillary of phase III clinical trial BLOCAGE01, NCT02313389 (Registered July 10, 2018-retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT03582254?term=LOCALYZE&draw=2&rank=1. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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