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Week one FLT-PET response predicts complete remission to R-CHOP and survival in DLBCL

Please always quote using this URN: urn:nbn:de:bvb:20-opus-120659
  • Despite improved survival in the Rituximab (R) era, a considerable number of patients with diffuse large B-cell lymphoma (DLBCL) ultimately die from the disease. Functional imaging using [18F]fluorodeoxyglucose-PET is suggested for assessment of residual viable tumor very early during treatment but is compromised by non-specific tracer retention in inflammatory lesions. The PET tracer [18F]fluorodeoxythymidine (FLT) as surrogate marker of tumor proliferation may overcome this limitation. We present results of a prospective clinical studyDespite improved survival in the Rituximab (R) era, a considerable number of patients with diffuse large B-cell lymphoma (DLBCL) ultimately die from the disease. Functional imaging using [18F]fluorodeoxyglucose-PET is suggested for assessment of residual viable tumor very early during treatment but is compromised by non-specific tracer retention in inflammatory lesions. The PET tracer [18F]fluorodeoxythymidine (FLT) as surrogate marker of tumor proliferation may overcome this limitation. We present results of a prospective clinical study testing FLT-PET as superior and early predictor of response to chemotherapy and outcome in DLBCL. 54 patients underwent FLT-PET prior to and one week after the start of R-CHOP chemotherapy. Repetitive FLT-PET imaging was readily implemented into the diagnostic work-up. Our data demonstrate that the reduction of FLT standard uptake valuemean (SUVmean) and SUVmax one week after chemotherapy was significantly higher in patients achieving complete response (CR, n=48; non-CR, n=6; p<0.006). Martingale-residual and Cox proportional hazard analyses showed a significant monotonous decrease of mortality risk with increasing change in SUV. Consistent with these results, early FLT-PET response showed relevant discriminative ability in predicting CR. In conclusion, very early FLT-PET in the course of R-CHOP chemotherapy is feasible and enables identification of patients at risk for treatment failure.show moreshow less

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Metadaten
Author: Ken Herrmann, Andreas K. Buck, Tibor Schuster, Kathrin Abbrederis, Christina Blümel, Ivan Santi, Martina Rudelius, Hans-Jürgen Wester, Christian Peschel, Markus Schwaiger, Tobias Dechow, Ulrich Keller
URN:urn:nbn:de:bvb:20-opus-120659
Document Type:Journal article
Faculties:Medizinische Fakultät / Klinik und Poliklinik für Nuklearmedizin
Medizinische Fakultät / Pathologisches Institut
Language:English
Parent Title (English):Oncotarget
ISSN:1949-2553
Year of Completion:2014
Volume:5
Issue:12
Pagenumber:4050-59
Source:Oncotarget, Vol. 5, No. 12, 4050-59
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:DLBCL; FLT-PET; [18F]Fluorodeoxythymidine; lymphoma; positron emission tomography
Release Date:2016/02/12
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung