Performance of CT Compared with 18F-FDG PET in Predicting the Efficacy of Nivolumab in Relapsed or Refractory Hodgkin Lymphoma
Autor: | Romain-David Seban, Anna Schmitt, Aiping Chen, Guillaume Manson, Jean-Marc Schiano de Colella, Lawrence H. Schwartz, Olivier Casasnovas, Fatima-Zohra Mokrane, Laurent Dercle, Apasia Stamatoullas, Laetitia Vercellino, Roch Houot, Remy Dulery, Marie-Pierre Moles-Moreau, Hervé Ghesquières, Frederic Peyrade, Emmanuelle Nicolas-Virelizier, Mohamed Touati, Franck Morschhauser, Adrien Chauchet, Krimo Bouabdallah, Benedicte Deau-Fischer, Cécile Borel, Alain Delmer |
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Rok vydání: | 2020 |
Předmět: |
Fluorodeoxyglucose
business.industry Retrospective cohort study medicine.disease 030218 nuclear medicine & medical imaging 3. Good health Lymphoma 03 medical and health sciences 0302 clinical medicine Interquartile range 030220 oncology & carcinogenesis medicine Refractory Hodgkin Lymphoma Radiology Nuclear Medicine and imaging Young adult Nivolumab business Nuclear medicine Pseudoprogression medicine.drug |
Zdroj: | Radiology. 295:651-661 |
ISSN: | 1527-1315 0033-8419 |
Popis: | Background CT and fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT performances following immune therapy are not well known in patients with relapsed or refractory Hodgkin lymphoma (RRHL). Purpose To compare CT and PET/CT for prognostic value of early response evaluation following nivolumab therapy. Materials and Methods This retrospective study included patients from 34 institutions who underwent early imaging response evaluation from July 2013 to April 2017. Three experienced readers classified imaging response by using Cheson et al and 2016 Lymphoma Response to Immunomodulatory Therapy Criteria as follows: complete (metabolic) response, partial (metabolic) response, stable disease or no metabolic response, or progressive (metabolic) disease. Primary CT and PET assessments were performed at a median of 2.0 months (interquartile range, 1.7-3.7 months) after nivolumab initiation. Kaplan-Meier analysis was used to determine the relationship of primary CT and PET assessment response categories to overall survival (OS). Agreements between primary and secondary imaging assessments were assessed by using κ analysis. Results A total of 45 patients (median age, 37 years; range, 18-77 years; 25 men) underwent a primary assessment using CT and PET/CT; 36 patients also underwent a subsequent assessment. Eleven patients (24%) died after a median follow-up of 21.2 months. CT and PET response categories were associated with OS (P = .03 for primary CT assessment; P = .02 for primary PET assessment). There was no pseudoprogression at primary CT and PET assessments. At the primary assessment, response categories by using CT were reclassified by using PET in 44% (20 of 45) of patients. Among these, 55% (11 of 20) were reclassified to complete metabolic response (complete metabolic response rate: 29% [13 of 45 patients] vs complete response rate: 4% [two of 45 patients]), with a 2-year OS probability of 100%. At the secondary assessment, complete response rate using CT increased to 17% (six of 36 patients), hence a better agreement with PET (κ = 0.78; P < .001). Conclusion Early CT and PET/CT at a median of 2 months after initiation of nivolumab predicted overall survival in relapsed or refractory Hodgkin lymphoma. Early PET detected additional patients with complete metabolic response. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Scott and Wang in this issue. |
Databáze: | OpenAIRE |
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