Multicenter development of a PET-based risk assessment tool for product-specific outcome prediction in large B-cell lymphoma patients undergoing CAR T-cell therapy.
CAR T-cell therapy
Extra-nodal involvement
Large B-cell lymphoma
MTV
Risk factors
Journal
European journal of nuclear medicine and molecular imaging
ISSN: 1619-7089
Titre abrégé: Eur J Nucl Med Mol Imaging
Pays: Germany
ID NLM: 101140988
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
received:
15
07
2023
accepted:
30
11
2023
pubmed:
20
12
2023
medline:
20
12
2023
entrez:
19
12
2023
Statut:
ppublish
Résumé
The emergence of chimeric antigen receptor (CAR) T-cell therapy fundamentally changed the management of individuals with relapsed and refractory large B-cell lymphoma (LBCL). However, real-world data have shown divergent outcomes for the approved products. The present study therefore set out to evaluate potential risk factors in a larger cohort. Our analysis set included 88 patients, treated in four German university hospitals and one Italian center, who had undergone 2-[ Extra-nodal involvement emerged as the most relevant of the conventional tumor and patient characteristics. Moreover, we found that inclusion of metabolic tumor volume (MTV) further improves outcome prediction. The hazard ratio for a PFS event was 1.68 per unit increase of our proposed risk score (95% confidence interval [1.20, 2.35], P = 0.003), which comprised both extra-nodal disease and lymphoma burden. While the most suitable MTV cut-off among patients receiving tisagenlecleucel was 11 mL, a markedly higher threshold of 259 mL showed optimal predictive performance in those undergoing axicabtagene ciloleucel treatment. Our analysis demonstrates that the presence of more than one extra-nodal lesion and higher MTV in LBCL are associated with inferior outcome after CAR T-cell treatment. Based on an assessment tool including these two factors, patients can be assigned to one of three risk groups. Importantly, as shown by our study, metabolic tumor burden might facilitate CAR T-cell product selection and reflect the individual need for bridging therapy.
Identifiants
pubmed: 38114616
doi: 10.1007/s00259-023-06554-0
pii: 10.1007/s00259-023-06554-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1361-1370Subventions
Organisme : German Research Foundation
ID : 451580403
Organisme : Wilhelm Sander Foundation
ID : 2018.087.1
Informations de copyright
© 2023. The Author(s).
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