In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

Martin Hutchings; Lale Kostakoglu; Jan Maciej Zaucha; Bogdan Malkowski; Alberto Biggi; Iwona Danielewicz; Annika Loft; Lena Specht; Dominick Lamonica; Myron S Czuczman; Christina Nanni; Pier Luigi Zinzani; Louis Diehl; Richard Stern; Morton Coleman

doi:10.1200/jco.2013.53.2838

In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

Martin Hutchings, Lale Kostakoglu, Jan Maciej Zaucha, Bogdan Malkowski, Alberto Biggi, Iwona Danielewicz, Annika Loft, Lena Specht, Dominick Lamonica, Myron S Czuczman, Christina Nanni, Pier Luigi Zinzani, Louis Diehl, Richard Stern, Morton Coleman

Department of Clinical Medicine

70 Citations (Scopus)

Abstract

PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding rapidly enough to be PET negative after one cycle. This prospective study aimed to assess the prognostic value of PET after one cycle of chemotherapy in HL and to assess the dynamics of FDG uptake after one cycle (PET1) and after two cycles (PET2).

PATIENTS AND METHODS: All PET scans were read by two blinded, independent reviewers in different countries, according to the Deauville five-point scale. The main end point was progression-free survival (PFS) after 2 years.

RESULTS: A total of 126 patients were included, and all had PET1; 89 patients had both PET1 and PET2. The prognostic value of PET1 was statistically significant with respect to both PFS and overall survival. Two-year PFS for PET1-negative and PET1-positive patients was 94.1% and 40.8%, respectively. Among those with both PET1 and PET2, 2-year PFS was 98.3% and 38.5% for PET1-negative and PET1-positive patients and 90.2% and 23.1% for PET2-negative and PET2-positive patients, respectively. No PET1-negative patient was PET2 positive.

CONCLUSION: PET after one cycle of chemotherapy is highly prognostic in HL. No other prognostic tool identifies a group of patients with HL with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.

Original language	English
Journal	Journal of Clinical Oncology
Volume	32
Issue number	25
Pages (from-to)	2705-2711
Number of pages	7
ISSN	0732-183X
DOIs	https://doi.org/10.1200/jco.2013.53.2838
Publication status	Published - 1 Sept 2014

Keywords

Adolescent
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Bleomycin
Dacarbazine
Disease-Free Survival
Doxorubicin
Female
Fluorodeoxyglucose F18
Hodgkin Disease
Humans
Male
Middle Aged
Multimodal Imaging
Positron-Emission Tomography
Prognosis
Prospective Studies
Radiopharmaceuticals
Survival Rate
Tomography, X-Ray Computed
Vinblastine
Young Adult

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Hutchings, M., Kostakoglu, L., Zaucha, J. M., Malkowski, B., Biggi, A., Danielewicz, I., Loft, A., Specht, L., Lamonica, D., Czuczman, M. S., Nanni, C., Zinzani, P. L., Diehl, L., Stern, R., & Coleman, M. (2014). In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma. Journal of Clinical Oncology, 32(25), 2705-2711. https://doi.org/10.1200/jco.2013.53.2838

In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma. / Hutchings, Martin; Kostakoglu, Lale; Zaucha, Jan Maciej et al.

In: Journal of Clinical Oncology, Vol. 32, No. 25, 01.09.2014, p. 2705-2711.

Research output: Contribution to journal › Journal article › Research › peer-review

Hutchings, M, Kostakoglu, L, Zaucha, JM, Malkowski, B, Biggi, A, Danielewicz, I, Loft, A, Specht, L, Lamonica, D, Czuczman, MS, Nanni, C, Zinzani, PL, Diehl, L, Stern, R & Coleman, M 2014, 'In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma', Journal of Clinical Oncology, vol. 32, no. 25, pp. 2705-2711. https://doi.org/10.1200/jco.2013.53.2838

@article{65bbc61394d040fd9f42c81eb87a55a6,

title = "In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma",

abstract = "PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding rapidly enough to be PET negative after one cycle. This prospective study aimed to assess the prognostic value of PET after one cycle of chemotherapy in HL and to assess the dynamics of FDG uptake after one cycle (PET1) and after two cycles (PET2).PATIENTS AND METHODS: All PET scans were read by two blinded, independent reviewers in different countries, according to the Deauville five-point scale. The main end point was progression-free survival (PFS) after 2 years.RESULTS: A total of 126 patients were included, and all had PET1; 89 patients had both PET1 and PET2. The prognostic value of PET1 was statistically significant with respect to both PFS and overall survival. Two-year PFS for PET1-negative and PET1-positive patients was 94.1% and 40.8%, respectively. Among those with both PET1 and PET2, 2-year PFS was 98.3% and 38.5% for PET1-negative and PET1-positive patients and 90.2% and 23.1% for PET2-negative and PET2-positive patients, respectively. No PET1-negative patient was PET2 positive.CONCLUSION: PET after one cycle of chemotherapy is highly prognostic in HL. No other prognostic tool identifies a group of patients with HL with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.",

keywords = "Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Bleomycin, Dacarbazine, Disease-Free Survival, Doxorubicin, Female, Fluorodeoxyglucose F18, Hodgkin Disease, Humans, Male, Middle Aged, Multimodal Imaging, Positron-Emission Tomography, Prognosis, Prospective Studies, Radiopharmaceuticals, Survival Rate, Tomography, X-Ray Computed, Vinblastine, Young Adult",

author = "Martin Hutchings and Lale Kostakoglu and Zaucha, {Jan Maciej} and Bogdan Malkowski and Alberto Biggi and Iwona Danielewicz and Annika Loft and Lena Specht and Dominick Lamonica and Czuczman, {Myron S} and Christina Nanni and Zinzani, {Pier Luigi} and Louis Diehl and Richard Stern and Morton Coleman",

note = "{\textcopyright} 2014 by American Society of Clinical Oncology.",

year = "2014",

month = sep,

day = "1",

doi = "10.1200/jco.2013.53.2838",

language = "English",

volume = "32",

pages = "2705--2711",

journal = "Journal of Clinical Oncology",

issn = "0732-183X",

publisher = "American Society of Clinical Oncology",

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TY - JOUR

T1 - In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

AU - Hutchings, Martin

AU - Kostakoglu, Lale

AU - Zaucha, Jan Maciej

AU - Malkowski, Bogdan

AU - Biggi, Alberto

AU - Danielewicz, Iwona

AU - Loft, Annika

AU - Specht, Lena

AU - Lamonica, Dominick

AU - Czuczman, Myron S

AU - Nanni, Christina

AU - Zinzani, Pier Luigi

AU - Diehl, Louis

AU - Stern, Richard

AU - Coleman, Morton

PY - 2014/9/1

Y1 - 2014/9/1

N2 - PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding rapidly enough to be PET negative after one cycle. This prospective study aimed to assess the prognostic value of PET after one cycle of chemotherapy in HL and to assess the dynamics of FDG uptake after one cycle (PET1) and after two cycles (PET2).PATIENTS AND METHODS: All PET scans were read by two blinded, independent reviewers in different countries, according to the Deauville five-point scale. The main end point was progression-free survival (PFS) after 2 years.RESULTS: A total of 126 patients were included, and all had PET1; 89 patients had both PET1 and PET2. The prognostic value of PET1 was statistically significant with respect to both PFS and overall survival. Two-year PFS for PET1-negative and PET1-positive patients was 94.1% and 40.8%, respectively. Among those with both PET1 and PET2, 2-year PFS was 98.3% and 38.5% for PET1-negative and PET1-positive patients and 90.2% and 23.1% for PET2-negative and PET2-positive patients, respectively. No PET1-negative patient was PET2 positive.CONCLUSION: PET after one cycle of chemotherapy is highly prognostic in HL. No other prognostic tool identifies a group of patients with HL with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.

AB - PURPOSE: Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding rapidly enough to be PET negative after one cycle. This prospective study aimed to assess the prognostic value of PET after one cycle of chemotherapy in HL and to assess the dynamics of FDG uptake after one cycle (PET1) and after two cycles (PET2).PATIENTS AND METHODS: All PET scans were read by two blinded, independent reviewers in different countries, according to the Deauville five-point scale. The main end point was progression-free survival (PFS) after 2 years.RESULTS: A total of 126 patients were included, and all had PET1; 89 patients had both PET1 and PET2. The prognostic value of PET1 was statistically significant with respect to both PFS and overall survival. Two-year PFS for PET1-negative and PET1-positive patients was 94.1% and 40.8%, respectively. Among those with both PET1 and PET2, 2-year PFS was 98.3% and 38.5% for PET1-negative and PET1-positive patients and 90.2% and 23.1% for PET2-negative and PET2-positive patients, respectively. No PET1-negative patient was PET2 positive.CONCLUSION: PET after one cycle of chemotherapy is highly prognostic in HL. No other prognostic tool identifies a group of patients with HL with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.

KW - Adolescent

KW - Adult

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Bleomycin

KW - Dacarbazine

KW - Disease-Free Survival

KW - Doxorubicin

KW - Female

KW - Fluorodeoxyglucose F18

KW - Hodgkin Disease

KW - Humans

KW - Male

KW - Middle Aged

KW - Multimodal Imaging

KW - Positron-Emission Tomography

KW - Prognosis

KW - Prospective Studies

KW - Radiopharmaceuticals

KW - Survival Rate

KW - Tomography, X-Ray Computed

KW - Vinblastine

KW - Young Adult

U2 - 10.1200/jco.2013.53.2838

DO - 10.1200/jco.2013.53.2838

M3 - Journal article

C2 - 25071108

SN - 0732-183X

VL - 32

SP - 2705

EP - 2711

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

IS - 25

ER -

In Vivo Treatment Sensitivity Testing With Positron Emission Tomography/Computed Tomography After One Cycle of Chemotherapy for Hodgkin Lymphoma

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Keywords

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