Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Interim PET/CT identifies poor-risk DLBCL patients after R-CHOP14

Key clinical point: Elevated SUVmax, MTV and TLG at interim PET/CT identified patients with shorter progression free survival and overall survival.

Major finding: A reduction of SUVmax > 66% in interim scans was associated with longer PFS (P = .0027) and OS (P < .0001)

Study details: PET scans were obtained at baseline and after 2 treatment cycles (interim PET) from 138 patients receiving 6 cycles of R-CHOP14 in the prospective SAKK38/07 study

Disclosures: The abstract contained no conflict information.

Commentary

“While interim PET/CT using Deauville criteria based on standardized uptake value (SUV) has proven to be prognostic and useful in guiding treatment decisions in Hodgkin lymphoma, its use has not been straightforward in diffuse large B-cell lymphoma (DLBCL). Drs. Zucca et al investigated 138 patients with DLBCL treated with R-CHOP14 who underwent PET/CT after 2 cycles of therapy. Parameters evaluated in the interim scans included SUV as well as mean tumor volume (MTV) and total lesion glycolysis (TLG). The change in SUV max was particularly useful as a prognostic factor on interim PET/CT in patients with high baseline MTV. Using these two parameters, the researchers developed a prognostic model that separated patients into three risk groups based on their interim PET/CT results. Future studies should incorporate novel treatment strategies for those in the unfavorable risk group after interim PET/CT.”

Sarah Rutherford, MD

Assistant Professor of Medicine, Weill Cornell Medicine

Citation:

Zucca E et al. European Hematology Association virtual annual meeting. 2020; Abstract S231.