Week one FLT-PET response predicts complete remission to R-CHOP and survival in DLBCL.
AuthorHerrmann, K; Buck, AK; Schuster, T; Abbrederis, K; Blümel, C; Santi, I; Rudelius, M; Wester, H-J; Peschel, C; Schwaiger, M; ...
PublisherImpact Journals, LLC
University of Melbourne Author/sSCHUSTER, TIBOR
Document TypeJournal Article
CitationsHerrmann, K., Buck, A. K., Schuster, T., Abbrederis, K., Blümel, C., Santi, I., Rudelius, M., Wester, H. -J., Peschel, C., Schwaiger, M., Dechow, T. & Keller, U. (2014). Week one FLT-PET response predicts complete remission to R-CHOP and survival in DLBCL.. Oncotarget, 5 (12), pp.4050-4059. https://doi.org/10.18632/oncotarget.1990.
Access StatusOpen Access
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147305
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.
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