FDG‐PET/CT after two cycles of R‐CHOP in DLBCL predicts complete remission but has limited value in identifying patients with poor outcome – final result of a UK National Cancer Research Institute prospective study
Key result
Interim PET/CT after two cycles of R-CHOP in DLBCL showed that only Deauville score 5 predicted inferior 5-year progression-free survival (47.6% vs 69.4-76.7% for DS 1-4; P=0.01).
Why the study?
The study was conducted to assess the prognostic value of early FDG-PET/CT in diffuse large B-cell lymphoma treated with R-CHOP.
Does early FDG-PET/CT after two cycles of R-CHOP predict complete remission and survival outcomes in patients with DLBCL?
Population
189 patients with DLBCL treated with R-CHOP
Comparison
PET2 response by Deauville score and DeltaSUVmax
Design
Prospective cohort study with central blinded reporting
Follow-up
Median 5.4 years
Authors
Discussion
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Member takes
Implication
DS 5 on interim PET/CT identifies high-risk DLBCL; leaves open whether PET-guided intensification improves outcomes.
Study Design
Type
Cohort (n=189)
Blinding
Blinded reporting
Multicenter
Yes
Structured PICO
Does early FDG-PET/CT after two cycles of R-CHOP predict complete remission and survival outcomes in patients with DLBCL?
P
Population
189 patients with diffuse large B-cell lymphoma treated with R-CHOP who underwent baseline and interim PET/CT, followed for a median of 5.4 years.
E
Exposure
Early fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) after two cycles of R-CHOP (PET2)
O
Outcome
Association of PET2 response with end-of-treatment CT, progression-free survival (PFS), and overall survival (OS)hard clinical
Main Result
p-value: p=<0.001
Early FDG-PET/CT after two cycles of R-CHOP in DLBCL predicts complete remission, but only a Deauville score of 5 identifies patients with poor progression-free and overall survival.
Cite This Study
Mikhaeel et al. (2020) conducted a cohort in Diffuse large B-cell lymphoma (DLBCL) (n=189). Early FDG-PET/CT (post-cycle-2) vs. Different Deauville scores (DS 1-5) was evaluated on End-of-treatment complete response rate on CT, progression-free survival, and overall survival (p=<0.001). Interim PET/CT after two cycles of R-CHOP in DLBCL showed that only Deauville score 5 predicted inferior 5-year progression-free survival (47.6% vs 69.4-76.7% for DS 1-4; P=0.01).