PET scan prognostic in frontline follicular lymphoma

  • Strati P & al.
  • Haematologica
  • 10 Oct 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • Maximum standardized uptake value (SUVmax) measured from pretreatment positron emission tomography (PET) scans predicts response to specific frontline therapies for advanced-stage follicular lymphoma.

Why this matters

  • PET-based imaging has improved cancer staging and histological classification, but its prognostic value is unclear.

Study design

  • Researchers analyzed health records of patients with advanced-stage FL without histological evidence of transformation (N=346; 55% men; median SUVmax, 11 [range, 1.5-42]).
  • Primary outcome: frontline treatment outcomes with SUVmax >18 (15%) vs ≤18.
  • Regimens included nonanthracycline-based regimens and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).
  • Funding: MD Anderson Cancer Center.

Key results

  • With SUVmax >18, complete response rates were lower with nonanthracycline-based regimens (45% vs 92%; P<.001 but not>
  • Data also showed shorter PFS with nonanthracycline-based regimens (77 months vs not reached; P=.02), but not R-CHOP (P=.73).
  • Patients with SUVmax >18 had shorter 8-year OS with nonanthracycline-based regimens (50% vs 85%; P=.001) and R-CHOP (70% vs 90%; P=.02).

Limitations

  • The study was retrospective and did not account for total metabolic tumor volume.

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