• DOI:10.1200/JCO.2011.35.0736
• Corpus ID: 207029231

Positron emission tomography-computed tomography (PET-CT) after induction therapy is highly predictive of patient outcome in follicular lymphoma: analysis of PET-CT in a subset of PRIMA trial participants.

@article{Trotman2011PositronET,
  title={Positron emission tomography-computed tomography (PET-CT) after induction therapy is highly predictive of patient outcome in follicular lymphoma: analysis of PET-CT in a subset of PRIMA trial participants.},
  author={Judith Trotman and Marion Fournier and Thierry Lamy and John Francis Seymour and Anne Sonet and Andrea Jan{\'i}kov{\'a} and Ofer Shpilberg and Emmanuel Gyan and Herv{\'e} Tilly and Jane A. Estell and Cecily J Forsyth and Didier Decaudin and Bettina Fabiani and Jean Gabarre and Bruno Salles and Eric W Van Den Neste and Danielle Canioni and Etienne Garin and Michael J. Fulham and Thierry Vander Borght and Gilles Andr{\'e} Salles},
  journal={Journal of clinical oncology : official journal of the American Society of Clinical Oncology},
  year={2011},
  volume={29 23},
  pages={
          3194-200
        }
}

• J. Trotman, M. Fournier, +18 authors G. Salles
• Published 10 August 2011
• Medicine
• Journal of clinical oncology : official journal of the American Society of Clinical Oncology

PURPOSE
The utility of [(18)F]fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessing response at the end of induction therapy is well documented in Hodgkin's and diffuse large B-cell lymphomas, but its role in follicular lymphoma (FL) remains undetermined. We investigated the prognostic significance of PET-CT performed after first-line therapy in patients with FL treated in the prospective Primary Rituximab and Maintenance (PRIMA) study.

PATIENTS AND METHODS
Results of PET-CT scans performed after induction immunochemotherapy were recorded retrospectively. Patients went on to either observation or rituximab maintenance per protocol independent of the PET-CT result. Patient characteristics and outcomes were then evaluated.

RESULTS
Of 122 PET-CT scans performed at the end of the induction immunochemotherapy, 32 (26%) were reported as positive by the local investigator. Initial demographic or disease characteristics did not differ between PET-CT-positive (PET-positive) and PET-CT-negative (PET-negative) patients. PET status correlated with conventional response criteria (P < .001). Patients remaining PET positive had a significantly (P < .001) inferior progression-free survival at 42 months of 32.9% (95% CI, 17.2% to 49.5%) compared with 70.7% (95% CI, 59.3% to 79.4%) in those who became PET negative. PET status, but not conventional response (complete response or complete response unconfirmed v partial response) according to IWC 1999, was an independent predictive factor for lymphoma progression. The risk of death was also increased in PET-positive patients (hazard ratio 7.0; P = .0011).

CONCLUSION
[(18)F]FDG PET-CT status at the end of immunochemotherapy induction in patients with FL is strongly predictive of outcome and should be considered a meaningful clinical end point in future studies.