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Title: Positron emission tomography-computed tomography (PET-CT) after induction therapy is highly predictive of patient outcome in follicular lymphoma: analysis of PET-CT in a subset of PRIMA trial participants
Authors: Forsyth, Cecily J ;Trotman, J.;Fournier, M;Lamy, T.;Seymour, J.F.;Sonet, A.;Janikova, A.;Shpilberg, O.;Gyan, E.;Tilly, H.;Estell, J.;Decaudin, D.;Fabiani, B.;Gabarre, J.;Salles, B.;Van Den Neste, E.;Canioni, D.;Garin, E.;Fulham, M.;Vander Borght, T.;Salles, G.
Issue Date: Aug-2011
Source: Volume 29, Issue 23, pp. 3194 - 3200
Journal title: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Abstract: PURPOSE: The utility of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessing response at the end of induction therapy is well documented in Hodgkin's and diffuse large B-cell lymphomas, but its role in follicular lymphoma (FL) remains undetermined. We investigated the prognostic significance of PET-CT performed after first-line therapy in patients with FL treated in the prospective Primary Rituximab and Maintenance (PRIMA) study. PATIENTS AND METHODS: Results of PET-CT scans performed after induction immunochemotherapy were recorded retrospectively. Patients went on to either observation or rituximab maintenance per protocol independent of the PET-CT result. Patient characteristics and outcomes were then evaluated. RESULTS: Of 122 PET-CT scans performed at the end of the induction immunochemotherapy, 32 (26%) were reported as positive by the local investigator. Initial demographic or disease characteristics did not differ between PET-CT-positive (PET-positive) and PET-CT-negative (PET-negative) patients. PET status correlated with conventional response criteria (P < .001). Patients remaining PET positive had a significantly (P < .001) inferior progression-free survival at 42 months of 32.9% (95% CI, 17.2% to 49.5%) compared with 70.7% (95% CI, 59.3% to 79.4%) in those who became PET negative. PET status, but not conventional response (complete response or complete response unconfirmed v partial response) according to IWC 1999, was an independent predictive factor for lymphoma progression. The risk of death was also increased in PET-positive patients (hazard ratio 7.0; P = .0011). CONCLUSION: [(18)F]FDG PET-CT status at the end of immunochemotherapy induction in patients with FL is strongly predictive of outcome and should be considered a meaningful clinical end point in future studies.
DOI: 10.1200/jco.2011.35.0736
ISSN: 0732-183x
Publicaton type: Journal Article
Keywords: Drug Therapy
Study or Trial: Randomized Controlled Clinical Trial/Controlled Clinical Trial
Appears in Collections:Haematology

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