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PETAL Trial: PET Yields Independent Predictors of DLBCL Outcomes

Key clinical point: PET scanning provided the only independent predictors of time to progression as well as progression free- and overall survival for DLBCL.

Major finding: Patients with high TMTV and poor iPET response had the worst outcome, with 2-year survival rates below 50%.

Study details: Total metabolic tumor volume (TMTV) and standardized uptake value (SUV)-based interim positron emission tomography (iPET) responses were assessed in 510 patients with DLBCL.

Disclosures: This work was supported by German cancer aid grants, Amgen Germany, and Roche Pharma. Several authors reported research funding and honoraria from pharmaceutical companies.


“While about two-thirds of patients with diffuse large B-cell lymphoma (DLBCL) are cured with standard frontline therapy, the remaining patients often have poor outcomes. Treatment changes based on interim PET (iPET) have not been proven in DLBCL. The PETAL trial investigated iPET in DLBCL using the conventional parameter of standardized uptake values (SUV) and also an investigational method of total metabolic tumor volume (TMTV) assessment in 510 patients with DLBCL who underwent iPET after 2 cycles of R-CHOP. The investigators report that those patients with high TMTV and poor SUV response on iPET have the worst outcomes, while those with high TMTV and good SUV response and those with low TMTV and poor SUV response have intermediate outcomes with regard to time to progression, progression free survival, and overall survival. TMTV and SUV on iPET may help to identify patients who would benefit from novel strategies and/or intensification of therapy."

Sarah Rutherford, MD

Assistant Professor of Medicine, Weill Cornell Medicine


Schmitz C et al. European Journal of Cancer 2020. 124: 25-36.