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PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts

Studies evaluating Positron Emission Tomography scan after 2 cycles of chemotherapy (PET2) in newly diagnosed diffuse large B cell lymphoma (DLBCL) are heterogeneous in patient characteristics, treatments and have conflicting results. Here we report association of PET2 with outcomes in two large ind...

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Autores principales: Desai, Sanjal H., Pederson, Levi, LaPlant, Betsy, Mwangi, Raphael, Maurer, Matthew, Young, Jason R., Macon, William R., King, Rebecca L., Wang, Yucai, Cerhan, James R., Feldman, Andrew, Inwards, David J., Micallef, Ivana, Johnston, Patrick, Porrata, Luis F., Ansell, Stephen M., Habermann, Thomas M., Witzig, Thomas E., Nowakowski, Grzegorz S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065135/
https://www.ncbi.nlm.nih.gov/pubmed/35504884
http://dx.doi.org/10.1038/s41408-022-00649-x
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author Desai, Sanjal H.
Pederson, Levi
LaPlant, Betsy
Mwangi, Raphael
Maurer, Matthew
Young, Jason R.
Macon, William R.
King, Rebecca L.
Wang, Yucai
Cerhan, James R.
Feldman, Andrew
Inwards, David J.
Micallef, Ivana
Johnston, Patrick
Porrata, Luis F.
Ansell, Stephen M.
Habermann, Thomas M.
Witzig, Thomas E.
Nowakowski, Grzegorz S.
author_facet Desai, Sanjal H.
Pederson, Levi
LaPlant, Betsy
Mwangi, Raphael
Maurer, Matthew
Young, Jason R.
Macon, William R.
King, Rebecca L.
Wang, Yucai
Cerhan, James R.
Feldman, Andrew
Inwards, David J.
Micallef, Ivana
Johnston, Patrick
Porrata, Luis F.
Ansell, Stephen M.
Habermann, Thomas M.
Witzig, Thomas E.
Nowakowski, Grzegorz S.
author_sort Desai, Sanjal H.
collection PubMed
description Studies evaluating Positron Emission Tomography scan after 2 cycles of chemotherapy (PET2) in newly diagnosed diffuse large B cell lymphoma (DLBCL) are heterogeneous in patient characteristics, treatments and have conflicting results. Here we report association of PET2 with outcomes in two large independent prospective cohorts of newly diagnosed DLBCL pts treated with two RCHOP-based regimens. The discovery cohort consisted of pts enrolled in single arm phase 2 MC078E study of lenalidomide with RCHOP (R2CHOP). The validation cohort consisted of RCHOP-treated pts from the Molecular Epidemiology Resource (MER) cohort. Pts who received 3-6 cycles of therapy and had PET2 were included in the study. Patients who progressed on PET2 were excluded. Revised response criteria 2007 were used to define PET2 response PET2 positive (PET2 + ) pts had inferior EFS [24-month EFS 45.5% vs 87.9%, HR 4.0, CI(95) (2.1–7.9), p < 0.0001) with a trend towards lower OS [24-months OS 77% vs 94.8%, HR 2.0, CI(95) (0.9–4.8), P = 0.1] than PET2 negative (PET2−) pts in MC078E cohort. PET2 + pts had an inferior EFS (24 month EFS 48.7% vs 81.6%, HR 2.9, CI(95) 2.0–4.2, p < 0.0001) and OS (24-month OS 68.6% vs 88.1%, HR 2.3, CI(95): 1.5–3.5, p < 0.0001) in the MER cohort. These results were consistent regardless of age, sex and in the subgroup of advanced stage and high-risk international prognostic index (IPI). For MER, PET2 + pts also had higher odds of positive end of treatment PET (OR: 17.3 (CI(95) 7.9–37.7), p < 0.001). PET2 is an early predictor DLBCL pts at high risk of progression and death in two independent prospective cohorts. PET2-guided risk-adapted strategies may improve outcomes, and should be explored in clinical trials.
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spelling pubmed-90651352022-05-04 PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts Desai, Sanjal H. Pederson, Levi LaPlant, Betsy Mwangi, Raphael Maurer, Matthew Young, Jason R. Macon, William R. King, Rebecca L. Wang, Yucai Cerhan, James R. Feldman, Andrew Inwards, David J. Micallef, Ivana Johnston, Patrick Porrata, Luis F. Ansell, Stephen M. Habermann, Thomas M. Witzig, Thomas E. Nowakowski, Grzegorz S. Blood Cancer J Article Studies evaluating Positron Emission Tomography scan after 2 cycles of chemotherapy (PET2) in newly diagnosed diffuse large B cell lymphoma (DLBCL) are heterogeneous in patient characteristics, treatments and have conflicting results. Here we report association of PET2 with outcomes in two large independent prospective cohorts of newly diagnosed DLBCL pts treated with two RCHOP-based regimens. The discovery cohort consisted of pts enrolled in single arm phase 2 MC078E study of lenalidomide with RCHOP (R2CHOP). The validation cohort consisted of RCHOP-treated pts from the Molecular Epidemiology Resource (MER) cohort. Pts who received 3-6 cycles of therapy and had PET2 were included in the study. Patients who progressed on PET2 were excluded. Revised response criteria 2007 were used to define PET2 response PET2 positive (PET2 + ) pts had inferior EFS [24-month EFS 45.5% vs 87.9%, HR 4.0, CI(95) (2.1–7.9), p < 0.0001) with a trend towards lower OS [24-months OS 77% vs 94.8%, HR 2.0, CI(95) (0.9–4.8), P = 0.1] than PET2 negative (PET2−) pts in MC078E cohort. PET2 + pts had an inferior EFS (24 month EFS 48.7% vs 81.6%, HR 2.9, CI(95) 2.0–4.2, p < 0.0001) and OS (24-month OS 68.6% vs 88.1%, HR 2.3, CI(95): 1.5–3.5, p < 0.0001) in the MER cohort. These results were consistent regardless of age, sex and in the subgroup of advanced stage and high-risk international prognostic index (IPI). For MER, PET2 + pts also had higher odds of positive end of treatment PET (OR: 17.3 (CI(95) 7.9–37.7), p < 0.001). PET2 is an early predictor DLBCL pts at high risk of progression and death in two independent prospective cohorts. PET2-guided risk-adapted strategies may improve outcomes, and should be explored in clinical trials. Nature Publishing Group UK 2022-05-03 /pmc/articles/PMC9065135/ /pubmed/35504884 http://dx.doi.org/10.1038/s41408-022-00649-x Text en © The Author(s) 2022 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 license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license 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 license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Desai, Sanjal H.
Pederson, Levi
LaPlant, Betsy
Mwangi, Raphael
Maurer, Matthew
Young, Jason R.
Macon, William R.
King, Rebecca L.
Wang, Yucai
Cerhan, James R.
Feldman, Andrew
Inwards, David J.
Micallef, Ivana
Johnston, Patrick
Porrata, Luis F.
Ansell, Stephen M.
Habermann, Thomas M.
Witzig, Thomas E.
Nowakowski, Grzegorz S.
PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title_full PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title_fullStr PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title_full_unstemmed PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title_short PET2 response associated with survival in newly diagnosed diffuse large B-cell lymphoma: results of two independent prospective cohorts
title_sort pet2 response associated with survival in newly diagnosed diffuse large b-cell lymphoma: results of two independent prospective cohorts
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9065135/
https://www.ncbi.nlm.nih.gov/pubmed/35504884
http://dx.doi.org/10.1038/s41408-022-00649-x
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