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Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma

Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma
Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma

The International Extranodal Lymphoma Study Group (IELSG) 26 study was designed to evaluate the role of (18)F-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL). We examined the prognostic impact of functional PET parameters at diagnosis. Metabolic activity defined by the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) was measured on baseline 18FDG PET/CT following a standard protocol in a prospectively enrolled cohort of 103 PMBCL patients. All received combination chemoimmunotherapy with doxorubicin- and rituximab-based regimens; 93 had consolidation radiotherapy. Cutoff values were determined using the receiver-operating characteristic curve. At a median follow-up of 36 months, progression-free survival (PFS) and overall survival (OS) were 87% and 94%, respectively. In univariate analysis, elevated MTV and TLG were significantly associated with worse PFS and OS. Only TLG retained statistical significance for both OS (P = .001) and PFS (P < .001) in multivariate analysis. At 5 years, OS was 100% for patients with low TLG vs 80% for those with high TLG (P = .0001), whereas PFS was 99% vs 64%, respectively (P < .0001). TLG on baseline PET appeared to be a powerful predictor of PMBCL outcomes and warrants further validation as a biomarker. The IELSG 26 study was registered at www.clinicaltrials.gov as #NCT00944567.

Adult, Antineoplastic Combined Chemotherapy Protocols, Area Under Curve, Disease-Free Survival, Female, Fluorodeoxyglucose F18, Humans, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse, Male, Mediastinal Neoplasms, Multimodal Imaging, Neoplasm Staging, Positron-Emission Tomography, Prognosis, Proportional Hazards Models, ROC Curve, Radiopharmaceuticals, Tomography, X-Ray Computed, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
0006-4971
950-6
Ceriani, Luca
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Martelli, Maurizio
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Zinzani, Pier Luigi
c8a817bb-0f54-4bde-90b2-d3339ed8fff5
Ferreri, Andrés J.M.
ce2b2989-3888-49b5-a623-5094175db3d7
Botto, Barbara
b7cc807b-0896-4175-b96d-db92da55017a
Stelitano, Caterina
d20ef370-c8f7-4b5c-8b76-22dda1ba2c15
Gotti, Manuel
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Cabras, Maria Giuseppina
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Rigacci, Luigi
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Gargantini, Livio
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Merli, Francesco
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Pinotti, Graziella
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Mannina, Donato
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Luminari, Stefano
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Stathis, Anastasios
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Russo, Eleonora
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Cavalli, Franco
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Giovanella, Luca
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Johnson, Peter W.M.
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Zucca, Emanuele
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Ceriani, Luca
5767bf0b-1df0-4479-90df-a3e0beb1c8b8
Martelli, Maurizio
32f72970-6db0-45ec-9246-6d074b504192
Zinzani, Pier Luigi
c8a817bb-0f54-4bde-90b2-d3339ed8fff5
Ferreri, Andrés J.M.
ce2b2989-3888-49b5-a623-5094175db3d7
Botto, Barbara
b7cc807b-0896-4175-b96d-db92da55017a
Stelitano, Caterina
d20ef370-c8f7-4b5c-8b76-22dda1ba2c15
Gotti, Manuel
4f57bdab-403d-42f2-bdb4-ff10b90f2859
Cabras, Maria Giuseppina
f7c7a6ff-7ced-45b8-9212-9a1385c765c4
Rigacci, Luigi
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Gargantini, Livio
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Merli, Francesco
2458f37d-011d-41d0-af5f-262c6a40b161
Pinotti, Graziella
c8994b6a-b578-426f-8e49-bd46f654c956
Mannina, Donato
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Luminari, Stefano
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Stathis, Anastasios
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Russo, Eleonora
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Cavalli, Franco
ce699517-7deb-4bad-8b14-afe749884b9e
Giovanella, Luca
f701b100-a7b6-4b35-9bb1-464bcc28a66c
Johnson, Peter W.M.
1afe5cab-d45a-4cfe-91d9-d212e03cf1f2
Zucca, Emanuele
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Ceriani, Luca, Martelli, Maurizio, Zinzani, Pier Luigi, Ferreri, Andrés J.M., Botto, Barbara, Stelitano, Caterina, Gotti, Manuel, Cabras, Maria Giuseppina, Rigacci, Luigi, Gargantini, Livio, Merli, Francesco, Pinotti, Graziella, Mannina, Donato, Luminari, Stefano, Stathis, Anastasios, Russo, Eleonora, Cavalli, Franco, Giovanella, Luca, Johnson, Peter W.M. and Zucca, Emanuele (2015) Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma. Blood, 126 (8), 950-6. (doi:10.1182/blood-2014-12-616474).

Record type: Article

Abstract

The International Extranodal Lymphoma Study Group (IELSG) 26 study was designed to evaluate the role of (18)F-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) in the management of primary mediastinal (thymic) large B-cell lymphoma (PMBCL). We examined the prognostic impact of functional PET parameters at diagnosis. Metabolic activity defined by the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) was measured on baseline 18FDG PET/CT following a standard protocol in a prospectively enrolled cohort of 103 PMBCL patients. All received combination chemoimmunotherapy with doxorubicin- and rituximab-based regimens; 93 had consolidation radiotherapy. Cutoff values were determined using the receiver-operating characteristic curve. At a median follow-up of 36 months, progression-free survival (PFS) and overall survival (OS) were 87% and 94%, respectively. In univariate analysis, elevated MTV and TLG were significantly associated with worse PFS and OS. Only TLG retained statistical significance for both OS (P = .001) and PFS (P < .001) in multivariate analysis. At 5 years, OS was 100% for patients with low TLG vs 80% for those with high TLG (P = .0001), whereas PFS was 99% vs 64%, respectively (P < .0001). TLG on baseline PET appeared to be a powerful predictor of PMBCL outcomes and warrants further validation as a biomarker. The IELSG 26 study was registered at www.clinicaltrials.gov as #NCT00944567.

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More information

Accepted/In Press date: 24 May 2015
e-pub ahead of print date: 20 August 2015
Keywords: Adult, Antineoplastic Combined Chemotherapy Protocols, Area Under Curve, Disease-Free Survival, Female, Fluorodeoxyglucose F18, Humans, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse, Male, Mediastinal Neoplasms, Multimodal Imaging, Neoplasm Staging, Positron-Emission Tomography, Prognosis, Proportional Hazards Models, ROC Curve, Radiopharmaceuticals, Tomography, X-Ray Computed, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't
Organisations: Clinical Trials Unit

Identifiers

Local EPrints ID: 410575
URI: http://eprints.soton.ac.uk/id/eprint/410575
ISSN: 0006-4971
PURE UUID: 7ddf58dd-0d32-4bd3-91f9-b9a5eb690e6f

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Date deposited: 09 Jun 2017 09:08
Last modified: 15 Jan 2020 17:35

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Contributors

Author: Luca Ceriani
Author: Maurizio Martelli
Author: Pier Luigi Zinzani
Author: Andrés J.M. Ferreri
Author: Barbara Botto
Author: Caterina Stelitano
Author: Manuel Gotti
Author: Maria Giuseppina Cabras
Author: Luigi Rigacci
Author: Livio Gargantini
Author: Francesco Merli
Author: Graziella Pinotti
Author: Donato Mannina
Author: Stefano Luminari
Author: Anastasios Stathis
Author: Eleonora Russo
Author: Franco Cavalli
Author: Luca Giovanella
Author: Peter W.M. Johnson
Author: Emanuele Zucca

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