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Title:

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

Document type:
Journal Article; Research Support, Non-U.S. Gov't; Article
Author(s):
Herrmann, Ken; Buck, Andreas K; Schuster, Tibor; Abbrederis, Kathrin; Blümel, Christina; Santi, Ivan; Rudelius, Martina; Wester, Hans-Jürgen; Peschel, Christian; Schwaiger, Markus; Dechow, Tobias; Keller, Ulrich
Abstract:
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 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.
Journal title abbreviation:
Oncotarget
Year:
2014
Journal volume:
5
Journal issue:
12
Pages contribution:
4050-9
Language:
eng
Fulltext / DOI:
doi:10.18632/oncotarget.1990
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/24979177
TUM Institution:
III. Medizinische Klinik und Poliklinik (Hämatologie / Onkologie); Klinik und Poliklinik für Nuklearmedizin
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