PET/CT-biomarkers enable risk stratification of patients with relapsed/refractory diffuse large B-cell lymphoma enrolled in the LOTIS-2 clinical trial
Authors
Alderuccio, JPReis, IM
Hamadani, M
Nachiappan, M
Leslom, S
Kahl, BS
Ai, WZ
Radford, John
Solh, M
Ardeshna, KM
Hess, BT
Lunning, MA
Zinzani, PL
Stathis, A
Carlo-Stella, C
Lossos, IS
Caimi, PF
Han, S
Yang, F
Kuker, RA
Moskowitz, CH
Affiliation
The Christie Hospital, Manchester, United KingdomIssue Date
2023
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Purpose: Significant progress has occurred in developing quantitative PET/CT biomarkers in diffuse large B-cell lymphoma (DLBCL). Total metabolic tumor volume (MTV) is the most extensively studied, enabling assessment of FDG-avid tumor burden associated with outcomes. However, prior studies evaluated the outcome of cytotoxic chemotherapy or chimeric antigen receptor T-cell without data on recently approved FDA agents. Therefore, we aimed to assess the prognosis of PET/CT-biomarkers in patients treated with loncastuximab tesirine. Patients and methods: We centrally reviewed screening PET/CT scans of patients with relapsed/refractory DLBCL enrolled in the LOTIS-2 (NCT03589469) study. MTV was obtained by computing individual volumes using the SUV ≥4.0 threshold. Other PET/CT metrics, clinical factors, and the International Metabolic Prognostic Index (IMPI) were evaluated. Logistic regression was used to assess the association between biomarkers and treatment response. Cox regression was used to determine the effect of biomarkers on time-to-event outcomes. We estimated biomarker prediction as continuous and binary variables defined by cutpoints. Results: Across 138 patients included in this study, MTV with a cutpoint of 96ml was the biomarker associated with the highest predictive performance in univariable and multivariable models to predict failure to achieve complete metabolic response (odds ratio =5.42; P= 0.002), progression-free survival (hazard ratio (HR)= 2.68; P= 0.002), and overall survival (HR= 3.09; P<.0001). IMPI demonstrated an appropriate performance; however, not better than MTV alone. Conclusions: Pretreatment MTV demonstrated robust risk-stratification, with those patients demonstrating high-MTV achieving lower responses and survival to loncastuximab tesirine in relapsed/refractory DLBCL.Citation
Alderuccio JP, Reis IM, Hamadani M, Nachiappan M, Leslom S, Kahl BS, et al. PET/CT-biomarkers enable risk stratification of patients with relapsed/refractory diffuse large B-cell lymphoma enrolled in the LOTIS-2 clinical trial. Clinical cancer research : an official journal of the American Association for Cancer Research. 2023 Oct 19. PubMed PMID: 37855688. Epub 2023/10/19. eng.Journal
Clinical Cancer ResearchDOI
10.1158/1078-0432.ccr-23-1561PubMed ID
37855688Additional Links
https://dx.doi.org/10.1158/1078-0432.ccr-23-1561Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1158/1078-0432.ccr-23-1561
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