Final Results of a Prospective Evaluation of the Predictive Value of Interim Positron Emission Tomography in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP-14 (SAKK 38/07)

Mamot, Christoph; Klingbiel, Dirk; Hitz, Felicitas; Renner, Christoph; Pabst, Thomas; Driessen, Christoph; Mey, Ulrich; Pless, Miklos; Bargetzi, Mario; Krasniqi, Fatime; Gigli, Federica; Hany, Thomas F.; Samarin, Andrei; Biaggi, Christine; Rusterholz, Corinne; Dirnhofer, Stephan; Zucca, Emanuele; Martinelli, Giovanni

doi:10.1200/jco.2014.58.9846

Cited by 159 publications

(152 citation statements)

References 27 publications

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“…In DLBCL, PET performed at the end of treatment has shown a high predictive value for PFS and OS. [28] Post-treatment persistent 18FDG uptake was found in 32% of evaluable patients, which was higher than expected compared to up to 20% of PET positivity in most DLBCL studies. [28] We did not detect a prognostic impact of post-treatment PET positivity in our current study.…”

Section: Discussionmentioning

confidence: 67%

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Pilorge

Harel

Ribrag

et al. 2016

Leukemia & Lymphoma

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Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a 78.9% survival over a 4.7-year median follow-up period. Ann Arbor stage IV and high age-adjusted international prognostic index were predictive of adverse outcome in univariate analysis. In multivariate analysis using a Cox model, only aa-IPI predicted long-term survival. While based on a limited number of cases, we suggested that radiotherapy may be useful as a consolidation modality in PB-DLBCL. We also suggested that positron emission tomography/ CT scan should be interpreted with caution due to a persistent [18F]fluorodeoxyglucose [18FDG] uptake of bone lesions even after remission in some in PB-DLBCL patients. Our study based on a homogeneous cohort of PB-DLBCL patients confirmed the favorable outcome of this DLBCL variant and support the implementation of prospective clinical trials in this disease. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 67%

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Pilorge

Harel

Ribrag

et al. 2016

Leukemia & Lymphoma

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show abstract

“…21,32 Secondly, some recent studies have shown end-of-treatment PET to carry the highest PPV compared to iPET. 16,41,42 Consequently, early biopsy of FDG-avid sites has been recommended, since, in one large prospective study, iPET-positive patients who were biopsy-negative displayed outcomes equivalent to those for iPET-negative patients, with the caveat that both patient groups were switched to R-ICE treatment intensification. 43 As in the vast majority of studies, however, we did not assess biopsies taken from iPETpositive residual masses.…”

Section: Discussionmentioning

confidence: 99%

Early treatment intensification with R-ICE and 90Y-ibritumomab tiuxetan (Zevalin)-BEAM stem cell transplantation in patients with high-risk diffuse large B-cell lymphoma patients and positive interim PET after 4 cycles of R-CHOP-14

et al. 2016

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I n the treatment of diffuse large B-cell lymphoma, a persistently positive [ 18 F]fluorodeoxyglucose positron emission tomography (PET) scan typically carries a poor prognosis. In this prospective multi-center phase II study, we sought to establish whether treatment intensification with R-ICE (rituximab, ifosfamide, carboplatin, and etoposide) chemotherapy followed by 90Y-ibritumomab tiuxetan-BEAM (BCNU, etoposide, cytarabine, and melphalan) for high-risk diffuse large B-cell lymphoma patients who are positive on interim PET scan after 4 cycles of R-CHOP-14 (rituximab, cyclophosphamide, doxorubicin, and prednisone) can improve 2-year progression-free survival from a historically unfavorable rate of 40% to a rate of 65%. Patients received 4 cycles of R-CHOP-14, followed by a centrally-reviewed PET performed at day 17-20 of cycle 4 and assessed according to International Harmonisation Project criteria. Median age of the 151 evaluable patients was 57 years, with 79% stages 3-4, 54% bulk, and 54% International Prognostic Index 3-5. Among the 143 patients undergoing interim PET, 101 (71%) were PET-negative (96 of whom completed R-CHOP), 42 (29%) were PETpositive (32 of whom completed R-ICE and 90Y-ibritumomab tiuxetan-BEAM). At a median follow up of 35 months, the 2-year progressionfree survival for PET-positive patients was 67%, a rate similar to that for

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“…Although risk-adaptive strategies based on interim PET scans can identify patients with DLBCL at risk for treatment failure, 2 recent prospective studies failed to show clinical benefit from switching therapy, indicating the need for more sensitive and specific selection methods. [40][41][42] Interim ctDNA monitoring has potential advantages over PET scans as a result of high tumor specificity, quantitative analysis, and temporal kinetics. Indeed, quantitative response kinetics may improve on response-adapted strategies in lymphomas.…”

Section: Interim Monitoringmentioning

confidence: 99%

Dynamic monitoring of circulating tumor DNA in non-Hodgkin lymphoma

Roschewski

Staudt

Wilson

2016

Blood

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Response assessment in lymphoma relies on imaging scans that do not capture biologic processes at the molecular level. Monitoring circulating tumor DNA (ctDNA) with next-generation sequencing–based assays can detect recurrent disease prior to scans and “liquid biopsies” for somatic mutations address tumor heterogeneity, clonal evolution, and mechanisms of resistance to guide precision treatment. Preanalytic collection and processing procedures should be validated and standardized. We describe emerging applications of ctDNA monitoring including real-time analysis of tumor dynamics, preclinical disease detection, and precision-directed treatment paradigms.

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Final Results of a Prospective Evaluation of the Predictive Value of Interim Positron Emission Tomography in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP-14 (SAKK 38/07)

Cited by 159 publications

References 27 publications

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Early treatment intensification with R-ICE and 90Y-ibritumomab tiuxetan (Zevalin)-BEAM stem cell transplantation in patients with high-risk diffuse large B-cell lymphoma patients and positive interim PET after 4 cycles of R-CHOP-14

Dynamic monitoring of circulating tumor DNA in non-Hodgkin lymphoma

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