Prognostic value of interim FDG-PET in DLBCL
- 1. !"# Prognostic value of interim FDG-PET in DLBCL
- 3. 背景：DLBCL的治疗现状 J Hematol Oncol.2020 Dec 14;13(1):175
- 4. Nat Rev Clin Oncol. 2017,10:631-645 背景：how to improve? 动态危险分层
- 7. 1. Positron Emission Tomography-Directed Therapy for Patients With Limited-Stage Diffuse Large B-Cell Lymphoma: Results of Intergroup National Clinical Trials Network Study S1001. 2. Prognostic value of interim FDG-PET in diffuse large cell lymphoma: results from the CALGB 50303 Clinical Trial. 3. Dynamic risk assessment based on positron emission tomography scanning in diffuse large B-cell lymphoma: Post-hoc analysis from the PETAL trial. 4. Interobserver Agreement of Interim and End-of-Treatment 18 F-FDG PET/CT in Diffuse Large B-Cell Lymphoma: Impact on Clinical Practice and Trials.(HOVON Imaging Working Group) 5. Can the SUVmax-liver-based interpretation improve prognostic accuracy of interim and posttreatment 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma? iPET在DLBCL意义的随机对照临床研究（部分）
- 8. ü iPET Scans in DLBCL : Is It Ready for Prime Time? Clin Lymphoma Myeloma Leuk.2016;16(12):655-661 ü Δ SUVmax for interim PET in DLBCL: old is new Blood. 2020;135(25):2202-2203 ü iPET-driven strategy in DLBCL :do we trust the driver? Blood.2017;129(23):3059-3070 ü The role of PET in the first-line treatment of in DLBCL Lancet Haematol.2021;8(1):e80-e93 ü Interim PET in lymphoma: from Deauville to Peking criteria. On the road, again… Leuk Lymphoma.2018;59(3):523-525 iPET在DLBCL意义:专家的疑虑
- 10. 文献背景 文献解读 文献讨论
- 11. Prognostic value of interim FDG-PET in DLBCL -Results from the CALGB 50303 Clinical Trial Blood.2020;135(25):2224-2234.
- 12. ? to identify biomarkers of response by FDG-PET ? to evaluate the use of ΔSUVmax in defining response 研究目的
- 13. 流程图
- 14. 入组人群特征
- 15. 基线SUVmax分布 ? median SUVmax :24.3 ? Range:5.9-77
- 16. “Low” = 1 / 2 / 3, “High” = 4 / 5 结果：采用DS方法评判iPET 结果 PFS OS
- 18. 结果：采用ΔSUVmax评判iPET 结果 PFS OS ü 2yr PFS：62.5% (95% CI: 42.8%– 91.4%) vs. 85.3% (95% CI: 79.4%–91.6%) ü 2yr OS： 68.8% (95% CI: 49.4%–95.7%) vs. 93.8% (95% CI: 89.8%–98.1%)
- 19. 结论： ü In this phase 3 prospective clinical trial, ΔSUV on iPET predicted OS in large cell lymphoma ü ΔSUV may be an imaging biomarker that can help guide clinical trials using PET response-adapted therapy
- 20. iPET-CT Guided Therapy of Aggressive Non-Hodgkin Lymphomas -Results from the PETAL Clinical Trial J Clin Oncol.2018 Jul 10;36(20):2024-2034
- 21. PETAL 研究： iPET-CT驱动的治疗策略 J Clin Oncol.2018 Jul 10;36(20):2024-2034
- 22. 入组人群特征
- 23. iPET-CT 结果判定：采用DS方法 EFS OS PETAL 研究： iPET-CT 结果对预后的影响 ü 2yr EFS：65.9% vs. 75.0% ü 2yr OS： 80.8% vs. 88.1%
- 24. PETAL 研究： iPET-CT 结果对预后的影响 iPET-CT 结果判定：采用ΔSUVmax方法 EFS OS ü 2yr EFS：36.7% vs. 75.6% ü 2yr OS： 59.3% vs. 88.2%
- 25. 搁翱颁曲线对两种判读方法的比较
- 26. J Clin Oncol.2018 Jul 10;36(20):2024-2034 PETAL 研究： iPET-CT 结果对预后的影响 ü采用ΔSUVmax方法判断iPET-CT 结果优于DS方法 üiPET-CT结果可以预测预后
- 27. J Nucl Med.2021 Jan;62(1):37-42 iPET evaluation in DLBCL employing published recommendations - Comparison of the Deauville 5-point scale and the ΔSUVmax method
- 28. Key points
- 29. J Clin Oncol.2015;33(23):2523-9 Predictive Value of iPET-CT in Patients With DLBCL Treated With R-CHOP-14 -Results from the SAKK 38/07 Clinical Trial
- 30. 流程图 R-CHOP-14
- 31. 结果：采用DS方法评判iPET 结果 ü 2yr EFS：41.4% vs. 75.9% ü 2yr OS： 93.9% vs. 84.0%
- 32. 结果：采用ΔSUVmax评判iPET 结果 ü 2yr EFS：42.1% vs. 61.2% (p=NS) ü 2yr OS： 73.7% vs. 91.3%
- 33. iPET-CT in DLBCL predicts CR but has limited value in identifying patients with poor outcome -final result of a UK National Cancer Research Institute prospective study Br J Haematol.2021 Feb;192(3):504-513
- 34. 文献背景 文献解读 文献讨论
- 35. Prognostic value of iPET in DLBCL？ ü结果异质性的原因？ ü 疾病的异质性？方法抑制性？
- 36. Eur J Nucl Med Mol Imaging. 2013;40(9):1312-1320. 既往研究的结果 一项国际多中心回顾研究 ? 评价iPET对DLBCL预后的意义 ? 采用DS评分法与ΔSUVmax方法
- 37. Eur J Nucl Med Mol Imaging. 2013;40(9):1312-1320. 既往研究的结果 一项国际多中心回顾研究 ? 评价iPET对DLBCL预后的意义 ? 采用DS评分法与ΔSUVmax方法
- 38. Prognostic value of iPET in DLBCL？ üiPET 的价值：依然在路上？