Page 141 - 18F-FDG PET as biomarker in aggressive lymphoma; technical and clinical validation

PET improves DLBCL response predictors
exploratory analysis the international GOYA randomized clinical trial found no PFS benefit with 8 cycles of R-CHOP21 compared with 6 cycles of R-CHOP21 +2 cycles of rituximab [31]. The S1001 study presented 4 cycles R-CHOP as the new standard for most patients with limited-stage disease [32].
Conclusions
In this large DLBCL study, I-PET after 4 cycles of R(R)-CHOP14 added predictive value to aaIPI for 2-y PFS, and both were independent response biomarkers in a multivariable Cox model, yielding a high NPV of 93% for 2-y PFS. Comparing the most commonly used DS and ∆SUVmax cutoffs, the optimal response criterion for I-PET4 to predict 2-y PFS was ∆SUVmax.
Disclosure
This work was supported by the Alpe d’HuZes/KWF fund, provided by the Dutch Cancer Society (VU2012-5848). Pieternella Lugtenburg receives research funding from Roche, Takeda, and Servier and honoraria for advisory boards from Roche, Takeda, Servier, Genmab, Celgene, and Genentech. Josée Zijlstra receives research funding from, and is on the advisory board for, Roche. No other potential conflict of interest relevant to this article was reported.
Key points
Question:
What value do baseline MTV and I-PET add to aaIPI in predicting 2-y PFS in DLBCL, and what are the optimal I-PET response criteria?
Pertinent findings:
aaIPI and ∆SUVmax were independent predictors for 2-y PFS in DLBCL. Six percent of patients had a high PPV of 65% resulting in poor survival outcome. ∆SUVmax outperformed Deauville score in 2-y PFS prediction
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