Welcome to Medivizor!

You're browsing our sample library. Feel free to continue browsing. You can also sign up for free to receive medical information specific to your situation.

Posted by on Sep 12, 2021 in Non-Hodgkin lymphoma | 0 comments

In a nutshell

This study investigated the role of PET/CT scanning in the treatment of patients with recurrent or hard-to-treat B-cell non-Hodgkin’s lymphoma (NHL) after T-cell therapy. This study found that PET/CT scanning helped predict the effectiveness and side effects of treatment for these patients.

Some background

Chemoimmunotherapy remains the standard first-line treatment for patients with B-cell NHL. While most patients respond to treatment, relapse (cancer recurrence) is common. Many patients also develop tumors that no longer respond to treatment (refractory). FDG-PET/CT scanning is used to evaluate how well patients respond to treatment. This scanning is used to visualize the cancer cells and help guide the course of treatment.

CAR T-cell therapy helps the immune system fight cancer cells. This treatment is usually given after chemotherapy. First, T-cells (immune cells) are removed from the blood and genetically modified to make a special protein called CAR. This protein helps the T-cells attack cancer cells. Then, these CAR T-cells are reintroduced into the patient to attack the cancer cells. It is unclear whether FDG-PET/CT scanning can help predict T-cell therapy outcomes for patients with B-cell NHL.

Methods & findings

This study looked at the results of a study that included 41 patients with relapsed or refractory B-cell NHL. FDG-PET/CT scanning was used before and after treatment to evaluate how well these patients responded to CAR T-cell therapy. Patients were followed up for an average of 7 months.

At follow-up, 92.7% of all patients responded to treatment. 58.5% achieved a complete response (no signs of cancer after treatment; CR). 34.1% achieved a partial response (tumor shrinkage). On average, patients were still alive for an average of 209 days, with an average of 132 days of no tumor growth or spread.

FDG is a radioactive form of glucose (sugar) that can be detected on a scan. Cancer cells absorb more FDG than healthy ones, so a high FDG uptake means that there are more cancer cells present. Significantly more patients with lower FDG uptake were still alive 1 year later than patients with higher uptake (100% vs. 44.9%). Also, significantly more patients with lower uptake were still alive without tumor growth or spread (59.6% vs. 0.0%).

Cytokine release syndrome (CRS) is a side effect of T-cell therapy. The treatment triggers the massive release of molecules called cytokines, which leads to various symptoms such as fever, tiredness, joint and muscle pain, or digestive problems. 82.9% of all patients developed CRS. 14.6% of cases were moderate. A high FDG uptake was significantly associated with 48.1% higher odds of developing CRS.

Coagulation disorders (blood unable to form clots) are another side effect of CAR T-cell therapy. 85.4% of patients had this side effect. Significantly more patients who had a high FDG uptake had this side effect than patients who had a lower uptake (25 patients, 96.2% vs. 6 patients, 54.5%).

The bottom line

This study found that PET/CT scanning helped predict the effectiveness and side effects of treatment for these patients. The authors suggest that this scanning may help guide chemotherapy treatment given before T-cell therapy.

The fine print

This study looked back in time to analyze medical records data. This study also had a small number of patients. Larger studies are needed to confirm these results.

Published By :

Frontiers in oncology

Date :

Aug 24, 2021

Original Title :

Tumor Burden Measured by 18F-FDG PET/CT in Predicting Efficacy and Adverse Effects of Chimeric Antigen Receptor T-Cell Therapy in Non-Hodgkin Lymphoma.

click here to get personalized updates