Seifert, Robert, Kersting, David ORCID: 0000-0002-8451-1830, Rischpler, Christoph, Sandach, Patrick, Ferdinandus, Justin, Fendler, Wolfgang P., Rahbar, Kambiz, Weckesser, Matthias, Umutlu, Lale, Hanoun, Christine, Huettmann, Andreas, Reinhardt, Hans Christian, von Tresckow, Bastian, Herrmann, Ken, Duehrsen, Ulrich and Schaefers, Michael . Interim FDG-PET analysis to identify patients with aggressive non-Hodgkin lymphoma who benefit from treatment intensification: a post-hoc analysis of the PETAL trial. Leukemia. LONDON: SPRINGERNATURE. ISSN 1476-5551

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Abstract

The randomized PETAL trial failed to demonstrate a benefit of interim FDG-PET (iPET)-based treatment intensification over continued standard therapy with CHOP (plus rituximab (R) in CD20-positive lymphomas). We hypothesized that PET analysis of all lymphoma manifestations may identify patients who benefitted from treatment intensification. A previously developed neural network was employed for iPET analysis to identify the highest pathological FDG uptake (max-SUVAI) and the mean FDG uptake of all lymphoma manifestations (mean-SUVAI). High mean-SUVAI uptake was determined separately for iPET-positive and iPET-negative patients. The endpoint was time-to-progression (TTP). There was a significant interaction of additional rituximab and mean-SUVAI in the iPET-negative group (HR = 0.6, p < 0.05). Patients with high mean-SUVAI had significantly prolonged TTP when treated with 6xR-CHOP + 2 R (not reached versus 52 months, p < 0.05), whereas max-SUVmanual failed to show an impact of additional rituximab. In the iPET-positive group, patients with high mean-SUVAI had a significantly longer TTP with (R-)CHOP than with the Burkitt protocol (14 versus 4 months, p < 0.01). Comprehensive iPET evaluation may provide new prognosticators in aggressive lymphoma. Additional application of rituximab was associated with prolonged TTP in iPET-negative patients with high mean-SUVAI. Comprehensive iPET interpretation could identify high-risk patients who benefit from study-specific interventions.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Seifert, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kersting, DavidUNSPECIFIEDorcid.org/0000-0002-8451-1830UNSPECIFIED
Rischpler, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sandach, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferdinandus, JustinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fendler, Wolfgang P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rahbar, KambizUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weckesser, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Umutlu, LaleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hanoun, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Huettmann, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reinhardt, Hans ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Tresckow, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herrmann, KenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duehrsen, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefers, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-680679
DOI: 10.1038/s41375-022-01713-y
Journal or Publication Title: Leukemia
Publisher: SPRINGERNATURE
Place of Publication: LONDON
ISSN: 1476-5551
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
B-CELL LYMPHOMA; RESPONSE ASSESSMENT; SCANMultiple languages
Oncology; HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/68067

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