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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
- Source :
- Hematological oncologyREFERENCES. 38(5)
- Publication Year :
- 2020
-
Abstract
- 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.
- Subjects :
- Male
Cancer Research
Vincristine
Standardized uptake value
Kaplan-Meier Estimate
03 medical and health sciences
0302 clinical medicine
International Prognostic Index
Positron Emission Tomography Computed Tomography
Post-hoc analysis
Antineoplastic Combined Chemotherapy Protocols
Medicine
Humans
Positron emission
Cyclophosphamide
business.industry
Hematology
General Medicine
medicine.disease
Prognosis
Clinical trial
Oncology
ROC Curve
Doxorubicin
030220 oncology & carcinogenesis
Prednisone
Rituximab
Female
Lymphoma, Large B-Cell, Diffuse
business
Nuclear medicine
Diffuse large B-cell lymphoma
Biomarkers
030215 immunology
medicine.drug
Subjects
Details
- ISSN :
- 10991069
- Volume :
- 38
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Hematological oncologyREFERENCES
- Accession number :
- edsair.doi.dedup.....b7d53a21a33b30f9e512384cdbc19460