Details

Autor(en) / Beteiligte

• Cottereau, A S
• Rebaud, L
• Trotman, J
• Feugier, P
• Nastoupil, L J
• Bachy, E
• Flinn, I W
• Haioun, C
• Ysebaert, L
• Bartlett, N L
• Tilly, H
• Casasnovas, O
• Ricci, R
• Portugues, C
• Buvat, I
• Meignan, M
• Morschhauser, F

Titel

Metabolic tumor volume predicts outcome in patients with advanced stage follicular lymphoma from the RELEVANCE trial

Ist Teil von

• Annals of oncology, 2024-01, Vol.35 (1), p.130-137

Ort / Verlag

England

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• We investigated the prognostic value of baseline positron emission tomography (PET) parameters for patients with treatment-naïve follicular lymphoma (FL) in the phase III RELEVANCE trial, comparing the immunomodulatory combination of lenalidomide and rituximab (R ) versus R-chemotherapy (R-chemo), with both regimens followed by R maintenance therapy. Baseline characteristics of the entire PET-evaluable population (n = 406/1032) were well balanced between treatment arms. The maximal standard uptake value (SUV ) and the standardized maximal distance between tow lesions (SD ) were extracted, the standardized distance between two lesions the furthest apart, were extracted. The total metabolic tumor volume (TMTV) was computed using the 41% SUV method. With a median follow-up of 6.5 years, the 6-year progression-free survival (PFS) was 57.8%, the median TMTV was 284 cm , SUV was 11.3 and SD was 0.32 m , with no significant difference between arms. High TMTV (>510 cm ) and FLIPI were associated with an inferior PFS (P = 0.013 and P = 0.006, respectively), whereas SUV and SD were not (P = 0.08 and P = 0.12, respectively). In multivariable analysis, follicular lymphoma international prognostic index (FLIPI) and TMTV remained significantly associated with PFS (P = 0.0119 and P = 0.0379, respectively). These two adverse factors combined stratified the overall population into three risk groups: patients with no risk factors (40%), with one factor (44%), or with both (16%), with a 6-year PFS of 67.7%, 54.5%, and 41.0%, respectively. No significant interaction between treatment arms and TMTV or FLIPI (P = 0.31 or P = 0.59, respectively) was observed. The high-risk group (high TMTV and FLIPI 3-5) had a similar PFS in both arms (P = 0.45) with a median PFS of 68.4% in the R-chemo arm versus 71.4% in the R arm. Baseline TMTV is predictive of PFS, independently of FLIPI, in patients with advanced FL even in the context of antibody maintenance.