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    FDG-PET/CT after two cycles of R-CHOP in DLBCL predicts complete remission but has limited value in identifying patients with poor outcome - final result of a UK National Cancer Research Institute prospective study

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    Authors
    Mikhaeel, N. G.
    Cunningham, D.
    Counsell, N.
    McMillan, A.
    Radford, John A
    Ardeshna, K. M.
    Lawrie, A.
    Smith, P.
    Clifton-Hadley, L.
    O'Doherty, M. J.
    Barrington, S. F.
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    Affiliation
    Guy's Cancer Centre, Guy's and St Thomas' Hospital NHS Trust and School of Cancer and Pharmaceutical sciences, King's College London University, London
    Issue Date
    2020
    
    Metadata
    Show full item record
    Abstract
    The UK National Cancer Research Institute initiated a prospective study (UKCRN-ID 1760) to assess the prognostic value of early fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in diffuse large B-cell lymphoma (DLBCL). In total, 189 patients with DLBCL treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) had baseline and post-cycle-2 PET (PET2) within a quality assurance framework. Treatment decisions were based on CT; PET2 was archived for central blinded reporting after treatment completion. The association of PET2 response with end-of-treatment CT, progression-free (PFS) and overall survival (OS) was explored. The end-of-treatment complete response rate on CT was 83·9%, 75·0%, 70·5%, 40·4% and 36·4% for Deauville score (DS) 1 (n = 34), 2 (n = 39), 3 (n = 46), 4 (n = 56) and 5 (n = 14) (P < 0·001); and 64·1% and 50·0% for the maximum standardised uptake value (?SUVmax ) of ?66% (n = 168) and <66% (n = 21), respectively (P = 0·25). After a median 5·4 years of follow-up, the 5-year PFS was 69·4%, 72·8%, 76·7%, 71·2% and 47·6% by DS 1-5 (P = 0·01); and 72·6% and 57·1% by ?SUVmax of ?66% and <66% (P = 0·03), respectively. The association with DS remained in multivariable analyses, and was consistent for OS. Early complete metabolic response (DS 1-3) at interim PET/CT after two cycles of R-CHOP in DLBCL was associated with a higher end-of-treatment complete and overall response rate; however, only DS-5 patients had inferior PFS and OS. Keywords: R-CHOP chemotherapy; diffuse large B-cell lymphoma (DLBCL); positron emission tomography (PET).
    Citation
    Mikhaeel NG, Cunningham D, Counsell N, McMillan A, Radford JA, Ardeshna KM, et al. FDG-PET/CT after two cycles of R-CHOP in DLBCL predicts complete remission but has limited value in identifying patients with poor outcome - final result of a UK National Cancer Research Institute prospective study. Br J Haematol. 2020.
    Journal
    British Journal of Haematology
    URI
    http://hdl.handle.net/10541/623164
    DOI
    10.1111/bjh.16875
    PubMed ID
    32621535
    Additional Links
    https://dx.doi.org/10.1111/bjh.16875
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1111/bjh.16875
    Scopus Count
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