Posted by Medivizor on Feb 20, 2018 in Hodgkin's lymphoma |
In a nutshell
This study analyzed PET/CT scans from new Hodgkin’s lymphoma patients after one (iPET1) or two (iPET2) cycles of ABVD chemotherapy. The study concluded that iPET2 is better than iPET1 at predicting ABVD outcomes in HL patients.
Some background
Interem PET/CT scanning is used to guide early treatment for new Hodgkin’s lymphoma (HL) patients. Depending on the scan results, treatment can be decreased, increased, or changed to a different therapy. For example, patients with limited disease may show negative scan results, which could lead to their treatment being decreased. PET/CT makes it easier to identify patients who can achieve better outcomes with less therapy or who need their therapies changed. It is not clear whether a scan after one or two cycles of chemotherapy can better predict outcomes.
Methods & findings
This study involved 310 newly diagnosed HL patients treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy with or without consolidative radiotherapy (RT). 34% of patients had early stage HL (stages I – IIA), and 66% of patients had advanced stage HL (stages IIB – IV). After initial treatment, all patients received iPET1. 64% of patients also received iPET2 after an additional ABVD cycle. Patients were followed for an average of 38.2 months.
58.5% of patients who received both iPET1 and iPET2 were fast responders to ABVD treatment (negative results on both scans). Of the remaining 41.5%, half were slow responders (positive iPET1 and negative iPET2 results) and half were non-responders (positive results on both scans). Positive iPET1 results were associated with a 59% chance of 3-year progression-free survival in early stage patients, and a 57% chance in advanced stage patients. Positive iPET2 results had even lower probabilities of 0 (early stage) and 40% (advanced stage).
Overall, the fast responders showed the best outcome, with an 88% chance of progression-free survival at 3 years. Slow responders showed the next best outcome, with a 77% chance, followed by non-responders at 34% (worst outcome).
The bottom line
The study concluded that iPET2 better predicts ABVD outcomes in HL patients. iPET2 differentiates between patients who do or do not respond to treatment. iPET1 can identify fast-responding patients with the best outcomes and guide their early treatment.
The fine print
Patients who showed positive iPET2 results and received more intense treatments were excluded from the response analysis. 198 patients received both iPET1 and iPET2, but only 176 of these patients had their results analyzed.
Published By :
Annals of oncology : official journal of the European Society for Medical Oncology
Original Title :
The predictive role of interim PET after the first chemotherapy cycle and sequential evaluation of response to ABVD in Hodgkin lymphoma patients – the Polish Lymphoma Research Group (PLRG) Observational Study.
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