Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies

Aldin, Angela; Umlauff, Lisa; Estcourt, Lise J; Collins, Gary S.; Moons, Karel G.M.; Engert, Andreas; Kobe, Carsten; Tresckow, Bastian von; Haque, M Zahirul; Foroutan, Farid; Kreuzberger, Nina; Trivella, Marialena; Skoetz, Nicole

doi:10.1002/14651858.cd012643.pub2

Cited by 26 publications

(31 citation statements)

References 234 publications

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“…[ 18 F]FDG PET/CT is used to accurately stage and assess treatment response in almost all cancers, including those in pediatric patients [ 9 – 12 ]. However, for pediatric bone and soft tissue sarcoma, the role of [ 18 F]FDG PET/CT is not clearly defined.…”

Section: Introductionmentioning

confidence: 99%

[18F]FDG PET/CT for evaluating early response to neoadjuvant chemotherapy in pediatric patients with sarcoma: a prospective single-center trial

et al. 2020

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Introduction This is a prospective, single-center trial in pediatric patients with sarcoma aiming to evaluate [18F]FDG PET/CT as a tool for early response assessment to neoadjuvant chemotherapy (neo-CTX). Methods Bone or soft tissue sarcoma patients with (1) baseline [18F]FDG PET/CT within 4 weeks prior to the start of neo-CTX (PET1), (2) early interim [18F]FDG PET/CT (6 weeks after the start of neo-CTX (PET2), (3) evaluation of neo-CTX response by histology or MRI, and (4) definitive therapy after neo-CTX (surgery or radiation) were included. Semiquantitative PET parameters (SUVmax, SUVmean, SUVpeak, MTV and TLG) and their changes from PET1 to PET2 (ΔPET) were obtained. The primary endpoint was to evaluate the predictive value of PET1, PET2 and ΔPET parameters for overall survival (OS) and time to progression (TTP). The secondary outcome was to evaluate if [18F]FDG PET/CT can predict the response to neo-CTX assessed by histopathology or MRI. Primary and secondary outcomes were also evaluated in a subpopulation of patients with bone involvement only. Results Thirty-four consecutive patients were enrolled (10 females; 24 males; median age 15.1 years). 17/34 patients (50%) had osteosarcoma, 13/34 (38%) Ewing's sarcoma, 2/34 (6%) synovial sarcoma and 2/34 (6%) embryonal liver sarcoma. Median follow-up was 39 months (range 16–84). Eight of 34 patients (24%) died, 9/34 (27%) were alive with disease, and 17/34 (50%) had no evidence of residual/recurrent disease. Fifteen of 34 (44%) and 19/34 (56%) were responders and non-responders, respectively. PET2-parameters were associated with longer TTP (p < 0.02). ΔMTV was associated with tissue response to neo-CTX (p = 0.047). None of the PET1, PET2 or ΔPET parameters were associated with OS. Conclusion [18F]FDG PET/CT performed 6 weeks after the start of neo-CTX can serve as an early interim biomarker for TTP and pathologic response but not for OS in pediatric patients with sarcoma.

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Section: Introductionmentioning

confidence: 99%

[18F]FDG PET/CT for evaluating early response to neoadjuvant chemotherapy in pediatric patients with sarcoma: a prospective single-center trial

et al. 2020

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“…Recently, PET response-adapted therapies have been assessed to improve efficacy and avoid toxicity. In addition to four studies reporting patients' response to PET responseadapted therapy [60,61,68,73,78], two recent SLRs have investigated PET and HL; one on interim PET results and prognosis concluded that negative interim PET results have a large advantage in terms of OS (moderate certainty evidence) [134]. A review of PET-adapted therapy for HL recommended a PET treatment approach as standard of care for advanced HL [135].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

Dalal

Gupta²,

Price³

et al. 2020

Expert Review of Hematology

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Objective: To assess evidence on the safety and efficacy of ABVD (doxorubicin [Adriamycin®], bleomycin, vinblastine, and dacarbazine), BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and A+AVD (brentuximab vedotin, with doxorubicin, vinblastine, and dacarbazine) for advanced-stage Hodgkin lymphoma (HL). Methods: A systematic literature review (SLR) was conducted on 29 July 2016 (updated 26 July 2018) to identify randomized controlled trials (RCTs) and non-RCTs assessing the treatment of newly-diagnosed advanced-stage HL with ABVD and BEACOPP (and their variants), and A+AVD. Results: The SLR identified 62 RCTs and 42 non-RCTs. Five-year overall survival rates for ABVD and BEACOPP were 60-97% and 84-99%, and 5-year progression-free survival rates were 58-81% and 83-96%, respectively. Both regimens were associated with tolerability issues and side effects. Discontinuation or dose reduction of bleomycin resulted in fewer adverse events, without significantly affecting efficacy. A head-to-head trial demonstrated improved efficacy for A+AVD vs ABVD, with an acceptable tolerability profile. No data from head-to-head trials comparing A+AVD with BEACOPP were available, and an indirect treatment comparison was not feasible. Conclusion: New therapies, such as A+AVD, maintain the efficacy observed with current treatments, and may provide a more tolerable treatment option for patients with advanced-stage HL.

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“…Conversely, early monitoring of chemosensitivity by PET‐2, can also enable dose de‐escalation by switching from eBEACOPP to ABVD, to reduce toxicity without loss of disease control 19 . However, among patients with a negative PET‐2 (as indicated by a DS of 1, 2, or 3), approximately 15% will eventually relapse or progress after the end of treatment, and only 60% to 67% are expected to be rescued by the more toxic regimen eBEACOPP at three to 5 years 20‐22 . Thus, PET‐2 has limited value for identify patients who will achieve long‐lasting complete remission (CR).…”

Section: Introductionmentioning

confidence: 99%

Early serum TARC reduction predicts prognosis in advanced‐stage Hodgkin lymphoma patients treated with a PET‐adapted strategy

Viviani

Mazzocchi

Pavoni

et al. 2020

Hematological Oncology

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Among patients with advanced-stage classical Hodgkin lymphoma (cHL) receiving ABVD chemotherapy, PET performed after the first two treatment cycles (PET-2) has prognostic value. However, 15% of patients with a negative PET-2 will experience treatment failure. Here we prospectively evaluated serum thymus and activationregulated chemokine (TARC) levels, to improve risk assessment in patients treated according to HD0607 PET-driven trial (#NCT00795613). In 266 patients with available serum samples, who have agreed to participate in a sub-study for assessment of the role of TARC monitoring, serum TARC levels were measured at baseline and at time of PET-2 by commercially available ELISA test kits. The primary end-point was to evaluate the association between TARC after 2 ABVD cycles and PFS. Median Previous study was presented in part during the

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Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies

Abstract: Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies.

Cited by 26 publications

References 234 publications

[18F]FDG PET/CT for evaluating early response to neoadjuvant chemotherapy in pediatric patients with sarcoma: a prospective single-center trial

[18F]FDG PET/CT for evaluating early response to neoadjuvant chemotherapy in pediatric patients with sarcoma: a prospective single-center trial

Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review

Early serum TARC reduction predicts prognosis in advanced‐stage Hodgkin lymphoma patients treated with a PET‐adapted strategy

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