[18F]FDG-PET/CT in DLBCL-patients treated with CAR-T cell therapy: potential for defining patient prognosis

IF 1.8 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Open Pub Date : 2025-06-01 DOI:10.1016/j.ejro.2025.100663

Helena A. Peters , Ben-Niklas Bärmann , Emil Novruzov , Daniel Weiss , Matthias Boschheidgen , Vivien Lorena Ivan , Nora Liebers , Johannes Fischer , Eduards Mamlins , Aleksandar Radujkovic , Guido Kobbe , Julian Kirchner , Peter Minko , Kathrin Nachtkamp , Paul Jäger , Christina Antke , Frederik L. Giesel , Sascha Dietrich , Gerald Antoch , Kai Jannusch

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Abstract

Objectives

The aim of this study is to evaluate the potential of [¹⁸F]FDG-PET/CT in terms of prognostic value and treatment monitoring in relapsed / refractory diffuse large B-cell lymphoma (DLBCL)-patients treated with chimeric antigen receptor T-cell (CAR-T) therapy.

Material & methods

Forty-eight [¹⁸F]FDG-PET/CT scans, acquired at pre-defined time points (t₀ – t₂) of 18 DLBCL-patients (mean age: 60 ± 12 years) treated with CAR-T cell therapy were retrospectively enrolled. Median time of follow-up was ten months (IQR 6–16) following CAR-T cell infusion. SUV_max, sum of the product of diameters (SPD), Deauville score (DS) and Lugano classification (LC) were evaluated. Clinical parameters (age, sex) were obtained. Survival time analyses for progression-free survival (PFS) and overall survival (OS) were calculated, the latter by using the Kaplan-Meier method and Cox regression including a hazard ratio (HR). P values below 0.05 were defined as statistically significant. 95 %-confidence intervals (CI) were calculated.

Results

Patients with a SUV_max> 9.0 at t₀ (median as threshold value) had a significantly shorter PFS (p = 0.04) and OS (p < 0.01). According to LC, a progressive disease (PD) at t₁ (p = 0.02) and t₂ (p < 0.01) was correlated with a reduced OS. SUV_max > 9.0 at t₀ (p = 0.03, HR = 7.0, CI: 1.3–40.5) and DS > 3 at t₁ (p = 0.04, HR = 8.2, CI: 1.1–61.3) were associated with an increased risk of a PD.

Conclusion

SUV_max of [¹⁸F]FDG-PET/CT seems to be useful as a prognostic marker in DLBCL-patients undergoing CAR-T cell therapy. Furthermore, scores of clinical established Deauville classification and Lugano response criteria acquired at post-CAR-T [¹⁸F]FDG-PET/CT might be an indicator for early therapy failure.

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[18]FDG-PET/CT对CAR-T细胞治疗的dlbcl患者预后的影响

本研究的目的是评估[18F]FDG-PET/CT在复发/难治性弥漫性大b细胞淋巴瘤（DLBCL）患者接受嵌合抗原受体t细胞（CAR-T）治疗的预后价值和治疗监测方面的潜力。材料,方法回顾性纳入18例接受CAR-T细胞治疗的dlbcl患者（平均年龄：60 ± 12岁）在预定时间点（0 - t2）获得的48张[18F]FDG-PET/CT扫描。CAR-T细胞输注后的中位随访时间为10个月（IQR 6-16）。对SUVmax、直径积和（SPD）、Deauville评分（DS）和Lugano分类（LC）进行评价。获得临床参数（年龄、性别）。计算无进展生存期（PFS）和总生存期（OS）的生存时间分析，后者采用Kaplan-Meier法和Cox回归，包括风险比（HR）。P值小于0.05定义为有统计学意义。计算95 %置信区间（CI）。结果在t0（中位数为阈值）时SUVmax>； 9.0的患者PFS （p = 0.04）和OS （p <； 0.01）显著缩短。根据LC， t1 （p = 0.02）和t2 （p <； 0.01）的进展性疾病（PD）与OS降低相关。SUVmax >； 9.0 at 0 （p = 0.03,HR = 7.0, CI: 1.3-40.5）和DS >； 3 at t1 （p = 0.04,HR = 8.2, CI: 1.1-61.3）与PD风险增加相关。结论FDG-PET/CT的suvmax [18F]可作为dlbcl患者接受CAR-T细胞治疗的预后指标。此外，car - t后FDG-PET/CT获得的临床建立的Deauville分级和Lugano反应标准评分[18F]可能是早期治疗失败的一个指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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