Early 18F-FDG PET/CT Response Predicts Survival in Relapsed or Refractory Hodgkin Lymphoma Treated with Nivolumab
| Autor: | Alain Delmer, Laurent Dercle, Guillaume Manson, Frederic Peyrade, Mohamed Touati, Romain-David Seban, Krimo Bouabdallah, Laetitia Vercellino, Aiping Chen, Adrien Chauchet, Roch Houot, Marie-Pierre Moles-Moreau, Anna Schmitt, Philippe Armand, Lawrence H. Schwartz, Cécile Borel, Emmanuelle Nicolas-Virelizier, Hervé Ghesquières, Remy Dulery, Franck Morschhauser, Benedicte Deau-Fischer, Apasia Stamatoullas, Jean-Marc Schiano de Colella, Fatima-Zohra Mokrane, Olivier Casasnovas |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty education.field_of_study business.industry Population Retrospective cohort study Progressive Metabolic Disease Pembrolizumab Gastroenterology 3. Good health 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Refractory Interquartile range 030220 oncology & carcinogenesis Internal medicine medicine Refractory Hodgkin Lymphoma Radiology Nuclear Medicine and imaging Nivolumab education business |
| Zdroj: | Journal of Nuclear Medicine. 61:649-654 |
| ISSN: | 2159-662X 0161-5505 |
| Popis: | Monoclonal antibodies (mAbs) against programmed cell death 1 (PD-1), such as nivolumab and pembrolizumab, are associated with high response rates in patients with relapsed or refractory classic Hodgkin lymphoma (HL). To date, no prognostic factor for overall survival (OS) has been established with these agents in HL. We examined whether the first early response assessment evaluated using 18F-FDG PET/CT may be associated with OS in this setting. Methods: This retrospective study included 45 patients from 34 institutions. In a masked, centralized review, 3 independent radiologists classified PET/CT scans obtained at a median of 2.0 mo (interquartile range, 1.7-3.7 mo) after nivolumab initiation using existing criteria (i.e., 2014 Lugano classification and 2016 LYRIC). Patients were classified according to 4 possible response categories: complete metabolic response (CMR), partial metabolic response (PMR), no metabolic response (NMR), or progressive metabolic disease (PMD). Because the OS of patients with NMR and PMR was similar, they were grouped together. OS was estimated using the Kaplan-Meier method and compared between groups using log-rank testing. Results: Eleven patients (24%) died after a median follow-up of 21.2 mo. The classification was identical between Lugano and LYRIC because all 16 progression events classified as indeterminate response per LYRIC were confirmed on subsequent evaluations. Both Lugano and LYRIC classified patients as CMR in 13 cases (29%), PMD in 16 (36%), NMR in 4 (9%), and PMR in 12 (27%). The 2-y OS probability was significantly different in patients with PMD (0.53; 95% confidence interval [95%CI], 0.32-0.87), NMR or PMR (0.80; 95%CI, 0.63-1.00), and CMR (1.00; 95%CI, 1.00-1.00) in the overall population (P = 0.02, 45 patients), as well as according to a landmark analysis at 3 mo (P = 0.05, 32 patients). Conclusion: In relapsed or refractory HL patients treated with anti-PD-1 mAbs, the first early PET/CT assessment using either Lugano or LYRIC predicted OS and allowed early risk stratification, suggesting that PET/CT might be used to develop risk-adapted strategies. |
| Databáze: | OpenAIRE |
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