Integration of baseline metabolic parameters and mutational profiles predicts long-term response to first-line therapy in DLBCL patients
a post hoc analysis of the SAKK38/07 study
Additional information
Authors
Genta S.,
Ghilardi G.,
Cascione L.,
Juskevicius D.,
Tzankov A.,
Schär S.,
Milan L.,
Pirosa M. C.,
Esposito F.,
Ruberto T.,
Giovanella L.,
Hayoz S.,
Mamot C.,
Dirnhofer S.,
Zucca E.,
Ceriani L.
Type
Journal Article
Year
2022
Language
English
Abstract
Accurate estimation of the progression risk after first-line therapy represents an unmet clinical need in diffuse large B-cell lymphoma (DLBCL). Baseline (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) parameters, together with genetic analysis of lymphoma cells, could refine the prediction of treatment failure. We evaluated the combined impact of mutation profiling and baseline PET/CT functional parameters on the outcome of DLBCL patients treated with the R-CHOP14 regimen in the SAKK38/07 clinical trial (NCT00544219). The concomitant presence of mutated SOCS1 with wild-type CREBBP and EP300 defined a group of patients with a favorable prognosis and 2-year progression-free survival (PFS) of 100%. Using an unsupervised recursive partitioning approach, we generated a classification-tree algorithm that predicts treatment outcomes. Patients with elevated metabolic tumor volume (MTV) and high metabolic heterogeneity (MH) (15%) had the highest risk of relapse. Patients with low MTV and favorable mutational profile (9%) had the lowest risk, while the remaining patients constituted the intermediate-risk group (76%). The resulting model stratified patients among three groups with 2-year PFS of 100%, 82%, and 42%, respectively (p < 0.001).
Keywords
PET/CT, Mutational profile, DLBCL, Lymphoma, Prognostic index
Journal
Cancers
Volume
14
Pages (or article number)
1018
Diffusion
License
CC BY
Visibility
Public
Status open access
Gold
