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Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting

SIMPLE SUMMARY: This study aimed to highlight limitations in the use of interim PET (iPET) for treatment decisions and prognostication in the frontline management of Hodgkin’s lymphoma. It reinforces the observation from the ECHELON-1 study that outcomes of patients with a positive interim PET who n...

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Autores principales: Zheng, Serena, Gupta, Kanika, Goyal, Piyush, Nakajima, Reiko, Michaud, Laure, Batlevi, Connie Lee, Hamlin, Paul A., Horwitz, Steven, Kumar, Anita, Matasar, Matthew J., Moskowitz, Alison J., Moskowitz, Craig H., Noy, Ariela, Palomba, M. Lia, Straus, David J., Von Keudell, Gottfried, Falchi, Lorenzo, Yahalom, Joachim, Zelenetz, Andrew D., Younes, Anas, Salles, Gilles, Schöder, Heiko, Joffe, Erel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046293/
https://www.ncbi.nlm.nih.gov/pubmed/36980646
http://dx.doi.org/10.3390/cancers15061760
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author Zheng, Serena
Gupta, Kanika
Goyal, Piyush
Nakajima, Reiko
Michaud, Laure
Batlevi, Connie Lee
Hamlin, Paul A.
Horwitz, Steven
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Moskowitz, Craig H.
Noy, Ariela
Palomba, M. Lia
Straus, David J.
Von Keudell, Gottfried
Falchi, Lorenzo
Yahalom, Joachim
Zelenetz, Andrew D.
Younes, Anas
Salles, Gilles
Schöder, Heiko
Joffe, Erel
author_facet Zheng, Serena
Gupta, Kanika
Goyal, Piyush
Nakajima, Reiko
Michaud, Laure
Batlevi, Connie Lee
Hamlin, Paul A.
Horwitz, Steven
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Moskowitz, Craig H.
Noy, Ariela
Palomba, M. Lia
Straus, David J.
Von Keudell, Gottfried
Falchi, Lorenzo
Yahalom, Joachim
Zelenetz, Andrew D.
Younes, Anas
Salles, Gilles
Schöder, Heiko
Joffe, Erel
author_sort Zheng, Serena
collection PubMed
description SIMPLE SUMMARY: This study aimed to highlight limitations in the use of interim PET (iPET) for treatment decisions and prognostication in the frontline management of Hodgkin’s lymphoma. It reinforces the observation from the ECHELON-1 study that outcomes of patients with a positive interim PET who nonetheless continue treatment with ABVD are not as dismal as previously described. Furthermore, we describe the performance of PET positivity grading by a quantitative measure based on SUV ratios compared to the subjective Deauville scoring. ABSTRACT: Recent prospective clinical trial data suggest that patients with Hodgkin’s lymphoma who continue treatment with ABVD, despite failing to attain a complete metabolic response on interim PET (PET2+), may fare better than previously published. We describe the outcomes of PET2+ patients who continued ABVD and compare the performance of a quantitative measure based on the lesion-to-liver SUV ratio (LLS qPET2+) to that of the subjective Deauville criteria (dvPET2+). We analyzed all patients with newly diagnosed advanced-stage Hodgkin lymphoma treated with frontline ABVD at the Memorial Sloan Kettering Cancer Center between 2008 and 2017. Eligibility was set to correspond with the RATHL inclusion criteria. Images were reviewed by two nuclear medicine physicians and discordant cases were resolved with a third expert in consensus. qPET2+ was defined as LLS ≥ 1.3. We identified 227 patients of whom 25% (57) were qPET2+, but only 14% (31) were dvPET2+. Forty-eight patients (84%) continued ABVD with a 3-year PFS of 70% for qPET2+ and 64% for dvPET2+. In conclusion, interim PET interpretation in clinical practice may be associated with a higher rate of scans deemed positive. Irrespective of the criteria for PET2 positivity, a subset of patients may continue ABVD without a dismal outcome.
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spelling pubmed-100462932023-03-29 Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting Zheng, Serena Gupta, Kanika Goyal, Piyush Nakajima, Reiko Michaud, Laure Batlevi, Connie Lee Hamlin, Paul A. Horwitz, Steven Kumar, Anita Matasar, Matthew J. Moskowitz, Alison J. Moskowitz, Craig H. Noy, Ariela Palomba, M. Lia Straus, David J. Von Keudell, Gottfried Falchi, Lorenzo Yahalom, Joachim Zelenetz, Andrew D. Younes, Anas Salles, Gilles Schöder, Heiko Joffe, Erel Cancers (Basel) Article SIMPLE SUMMARY: This study aimed to highlight limitations in the use of interim PET (iPET) for treatment decisions and prognostication in the frontline management of Hodgkin’s lymphoma. It reinforces the observation from the ECHELON-1 study that outcomes of patients with a positive interim PET who nonetheless continue treatment with ABVD are not as dismal as previously described. Furthermore, we describe the performance of PET positivity grading by a quantitative measure based on SUV ratios compared to the subjective Deauville scoring. ABSTRACT: Recent prospective clinical trial data suggest that patients with Hodgkin’s lymphoma who continue treatment with ABVD, despite failing to attain a complete metabolic response on interim PET (PET2+), may fare better than previously published. We describe the outcomes of PET2+ patients who continued ABVD and compare the performance of a quantitative measure based on the lesion-to-liver SUV ratio (LLS qPET2+) to that of the subjective Deauville criteria (dvPET2+). We analyzed all patients with newly diagnosed advanced-stage Hodgkin lymphoma treated with frontline ABVD at the Memorial Sloan Kettering Cancer Center between 2008 and 2017. Eligibility was set to correspond with the RATHL inclusion criteria. Images were reviewed by two nuclear medicine physicians and discordant cases were resolved with a third expert in consensus. qPET2+ was defined as LLS ≥ 1.3. We identified 227 patients of whom 25% (57) were qPET2+, but only 14% (31) were dvPET2+. Forty-eight patients (84%) continued ABVD with a 3-year PFS of 70% for qPET2+ and 64% for dvPET2+. In conclusion, interim PET interpretation in clinical practice may be associated with a higher rate of scans deemed positive. Irrespective of the criteria for PET2 positivity, a subset of patients may continue ABVD without a dismal outcome. MDPI 2023-03-14 /pmc/articles/PMC10046293/ /pubmed/36980646 http://dx.doi.org/10.3390/cancers15061760 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zheng, Serena
Gupta, Kanika
Goyal, Piyush
Nakajima, Reiko
Michaud, Laure
Batlevi, Connie Lee
Hamlin, Paul A.
Horwitz, Steven
Kumar, Anita
Matasar, Matthew J.
Moskowitz, Alison J.
Moskowitz, Craig H.
Noy, Ariela
Palomba, M. Lia
Straus, David J.
Von Keudell, Gottfried
Falchi, Lorenzo
Yahalom, Joachim
Zelenetz, Andrew D.
Younes, Anas
Salles, Gilles
Schöder, Heiko
Joffe, Erel
Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title_full Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title_fullStr Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title_full_unstemmed Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title_short Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
title_sort outcomes of patients with positive interim positron emission tomography (pet) continuing abvd in the clinical setting
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046293/
https://www.ncbi.nlm.nih.gov/pubmed/36980646
http://dx.doi.org/10.3390/cancers15061760
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