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Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria

BACKGROUND: Chimeric antigen receptor T-cell therapy (CART) prolongs survival for patients with refractory or relapsed lymphoma. Discrepancies among different response criteria for lymphoma under CART were recently shown. Our objective was to evaluate reasons for discordance among different response...

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Autores principales: Winkelmann, Michael, Blumenberg, Viktoria, Rejeski, Kai, Bücklein, Veit L., Ingenerf, Maria, Unterrainer, Marcus, Schmidt, Christian, Dekorsy, Franziska J., Bartenstein, Peter, Ricke, Jens, von Bergwelt-Baildon, Michael, Subklewe, Marion, Kunz, Wolfgang G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184388/
https://www.ncbi.nlm.nih.gov/pubmed/37189191
http://dx.doi.org/10.1186/s40644-023-00566-7
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author Winkelmann, Michael
Blumenberg, Viktoria
Rejeski, Kai
Bücklein, Veit L.
Ingenerf, Maria
Unterrainer, Marcus
Schmidt, Christian
Dekorsy, Franziska J.
Bartenstein, Peter
Ricke, Jens
von Bergwelt-Baildon, Michael
Subklewe, Marion
Kunz, Wolfgang G.
author_facet Winkelmann, Michael
Blumenberg, Viktoria
Rejeski, Kai
Bücklein, Veit L.
Ingenerf, Maria
Unterrainer, Marcus
Schmidt, Christian
Dekorsy, Franziska J.
Bartenstein, Peter
Ricke, Jens
von Bergwelt-Baildon, Michael
Subklewe, Marion
Kunz, Wolfgang G.
author_sort Winkelmann, Michael
collection PubMed
description BACKGROUND: Chimeric antigen receptor T-cell therapy (CART) prolongs survival for patients with refractory or relapsed lymphoma. Discrepancies among different response criteria for lymphoma under CART were recently shown. Our objective was to evaluate reasons for discordance among different response criteria and their relation to overall survival. METHODS: Consecutive patients with baseline and follow-up imaging at 30 (FU1) and 90 days (FU2) after CART were included. Overall response was determined based on Lugano, Cheson, response evaluation criteria in lymphoma (RECIL) and lymphoma response to immunomodulatory therapy criteria (LYRIC). Overall response rate (ORR) and rates of progressive disease (PD) were determined. For each criterion reasons for PD were analyzed in detail. RESULTS: 41 patients were included. ORR was 68%, 68%, 63%, and 68% at FU2 by Lugano, Cheson, RECIL, and LYRIC, respectively. PD rates differed among criteria with 32% by Lugano, 27% by Cheson, 17% by RECIL, and 17% by LYRIC. Dominant reasons for PD according to Lugano were target lesion (TL) progression (84.6%), new appearing lesions (NL; 53.8%), non-TL progression (27.3%), and progressive metabolic disease (PMD; 15.4%). Deviations among the criteria for defining PD were largely explained by PMD of preexisting lesions that are defined as PD only by Lugano and non-TL progression, which is not defined as PD by RECIL and in some cases classified as indeterminate response by LYRIC. CONCLUSIONS: Following CART, lymphoma response criteria show differences in imaging endpoints, especially in defining PD. The response criteria must be considered when interpreting imaging endpoints and outcomes from clinical trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40644-023-00566-7.
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spelling pubmed-101843882023-05-16 Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria Winkelmann, Michael Blumenberg, Viktoria Rejeski, Kai Bücklein, Veit L. Ingenerf, Maria Unterrainer, Marcus Schmidt, Christian Dekorsy, Franziska J. Bartenstein, Peter Ricke, Jens von Bergwelt-Baildon, Michael Subklewe, Marion Kunz, Wolfgang G. Cancer Imaging Research Article BACKGROUND: Chimeric antigen receptor T-cell therapy (CART) prolongs survival for patients with refractory or relapsed lymphoma. Discrepancies among different response criteria for lymphoma under CART were recently shown. Our objective was to evaluate reasons for discordance among different response criteria and their relation to overall survival. METHODS: Consecutive patients with baseline and follow-up imaging at 30 (FU1) and 90 days (FU2) after CART were included. Overall response was determined based on Lugano, Cheson, response evaluation criteria in lymphoma (RECIL) and lymphoma response to immunomodulatory therapy criteria (LYRIC). Overall response rate (ORR) and rates of progressive disease (PD) were determined. For each criterion reasons for PD were analyzed in detail. RESULTS: 41 patients were included. ORR was 68%, 68%, 63%, and 68% at FU2 by Lugano, Cheson, RECIL, and LYRIC, respectively. PD rates differed among criteria with 32% by Lugano, 27% by Cheson, 17% by RECIL, and 17% by LYRIC. Dominant reasons for PD according to Lugano were target lesion (TL) progression (84.6%), new appearing lesions (NL; 53.8%), non-TL progression (27.3%), and progressive metabolic disease (PMD; 15.4%). Deviations among the criteria for defining PD were largely explained by PMD of preexisting lesions that are defined as PD only by Lugano and non-TL progression, which is not defined as PD by RECIL and in some cases classified as indeterminate response by LYRIC. CONCLUSIONS: Following CART, lymphoma response criteria show differences in imaging endpoints, especially in defining PD. The response criteria must be considered when interpreting imaging endpoints and outcomes from clinical trials. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40644-023-00566-7. BioMed Central 2023-05-15 /pmc/articles/PMC10184388/ /pubmed/37189191 http://dx.doi.org/10.1186/s40644-023-00566-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Winkelmann, Michael
Blumenberg, Viktoria
Rejeski, Kai
Bücklein, Veit L.
Ingenerf, Maria
Unterrainer, Marcus
Schmidt, Christian
Dekorsy, Franziska J.
Bartenstein, Peter
Ricke, Jens
von Bergwelt-Baildon, Michael
Subklewe, Marion
Kunz, Wolfgang G.
Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title_full Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title_fullStr Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title_full_unstemmed Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title_short Staging of lymphoma under chimeric antigen receptor T-cell therapy: reasons for discordance among imaging response criteria
title_sort staging of lymphoma under chimeric antigen receptor t-cell therapy: reasons for discordance among imaging response criteria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184388/
https://www.ncbi.nlm.nih.gov/pubmed/37189191
http://dx.doi.org/10.1186/s40644-023-00566-7
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