{"title":"THE ROLE OF ARTIFICIAL INTELLIGENCE IN IMAGING READINGS","authors":"I. Buvat","doi":"10.1002/hon.70093_9","DOIUrl":"https://doi.org/10.1002/hon.70093_9","url":null,"abstract":"<p>Artificial intelligence (AI) is gaining ground in medical imaging thanks to the increasing availability of open datasets and shared deep learning models. In the context of imaging readings, it can mainly serve two purposes. The first is to automate the detection of abnormalities and the extraction of quantitative features from the images. The second is to predict the future of the patient based on image content possibly supplemented by clinical, pathological and/or biological information.</p><p>In this talk, we will show that AI can already be used to automate a number of tedious tasks often prone to intra- and inter-reader variability, such as lesion detection and segmentation from whole-body [18F]-FDG PET/CT images. This enables automated calculation of prognostic biomarkers from these images, such as the total metabolically active tumor volume, and exploration of the prognostic or predictive values of numerous candidate radiomic biomarkers. We will also discuss the variability between different AI algorithms, requiring the establishment of benchmarks to determine the performance of each AI algorithm and its compliance with interpretation rules agreed by medical experts.</p><p>In a second part, we will present the challenging task of predicting treatment response or patient outcome based on image readings. We'll explain how AI can help make the most of image content. The differences between using end-to-end deep learning and using radiomic features associated with machine learning will be explained, highlighting the advantages and limitations of each approach for prediction tasks. In addition to medical images, the inclusion of non-imaging data in prognostic and predictive models may be necessary to improve performance. We will illustrate how this can be achieved. The challenges associated with using AI for inference will be described based on examples from the literature and our own experience.</p><p><b>Keywords:</b> diagnostic and prognostic biomarkers; PET-CT; risk models</p><p>No potential sources of conflict of interest.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Shen, B. S. Imber, C. C. Pinnix, J. Yahalom, A. Cajo, J. R. Gunther, T. Lin, M. P. MacManus, M. Bressel, M. Levis, U. Ricardi, C. L. Holloway, A. K. Ng, L. S. Constine, T. C. Igwe, D. Huang, D. C. Hodgson, Y. Y. Sum, J. P. Plastaras, J. A. Baron, M. Harris, T. Illidge, S. Taguchi, M. Oguchi, J. L. Brady, N. G. Mikhaeel, Y. D. Tseng, S. Davis, K. Elsayad, H. Eich, M. S. Binkley, A. Hashmi, L. K. Ballas, K. W. Yeoh, I. H. Sin, A. Wirth
{"title":"ULTRA-LOW DOSE RADIOTHERAPY (ULDR) (4Gy) FOR INDOLENT ORBITAL ADNEXAL LYMPHOMAS (IOAL): AN INTERNATIONAL LYMPHOMA RADIATION ONCOLOGY GROUP STUDY","authors":"L. Shen, B. S. Imber, C. C. Pinnix, J. Yahalom, A. Cajo, J. R. Gunther, T. Lin, M. P. MacManus, M. Bressel, M. Levis, U. Ricardi, C. L. Holloway, A. K. Ng, L. S. Constine, T. C. Igwe, D. Huang, D. C. Hodgson, Y. Y. Sum, J. P. Plastaras, J. A. Baron, M. Harris, T. Illidge, S. Taguchi, M. Oguchi, J. L. Brady, N. G. Mikhaeel, Y. D. Tseng, S. Davis, K. Elsayad, H. Eich, M. S. Binkley, A. Hashmi, L. K. Ballas, K. W. Yeoh, I. H. Sin, A. Wirth","doi":"10.1002/hon.70093_109","DOIUrl":"https://doi.org/10.1002/hon.70093_109","url":null,"abstract":"<p><b>Introduction:</b> ULDR is reported to be effective for a range of indolent lymphomas. This is particularly relevant for lymphomas of the orbit where standard radiotherapy doses may be associated with long term sequelae. This large, international retrospective study evaluates the efficacy of 4Gy radiotherapy including outcomes in patient subsets and late toxicity.</p><p><b>Methods:</b> Eligible patients received 4Gy radiotherapy for IOAL at 18 centres between 2006 and 2024. Of 320 patients entered, a preliminary analysis was performed for 270 patients (321 orbits) with complete data available. Freedom from local failure (FFLF) was measured from commencement of radiotherapy (or from date of first response assessment for the landmark analysis). The study met local institutional review board requirements.</p><p><b>Results:</b> The median age at diagnosis of IOAL was 68 years (range 22–97), with 58% females. Histology was marginal zone lymphoma in 66% of orbits and location was conjunctival (solely) in 23%. Radiotherapy was given to the whole orbit in 72% of orbits, conjunctiva only in 19% and other partial orbit volumes in 9%. The median followup was 2.4 years (inter-quartile range 1–4.3). Initial complete and partial response rates (per orbit) were 64% (95% CI: 58–69) and 34% (95% CI: 29–40) respectively, at a median of 72 days following RT. Five-year FFLF was 86% (95% CI: 80–90) for all treated orbits. In a landmark analysis five-year FFLF was 90% (95% CI: 83–95) after an initial CR to radiotherapy, and 83% (95% CI: 73–89) after an initial PR (Figure). Five-year FFLP were 89% (95% CI: 83–93) and 78% (95% CI: 65–87) for marginal zone lymphoma (MZL) and other histologies, respectively; and 86% (95% CI: 80–91) and 84% (95% CI: 71–91) for conjunctiva-only and other subsites, respectively. Symptoms were reported prior to radiotherapy in 91% of orbits. Complete and partial symptom resolution were reported in 70% and 25% of orbits, respectively. Late effects were uncommon and mild, including dry eye in 16% (all grade 1), cataract in 5%, retinopathy in 1% and glaucoma in < 1%.</p><p><b>Conclusion:</b> In a large, multicentre experience of ULDR for IOAL, durable local control and symptom relief were achieved for the large majority of treated orbits, and with no reported long-term sequelae in 80%. This preliminary analysis also suggests numerically superior outcomes for orbits achieving initial CR and for MZL histology. A final analysis of all enrolled patients is pending.</p><p><b>Keywords:</b> radiation therapy; extranodal non-Hodgkin lymphoma; indolent non-Hodgkin lymphoma</p><p><b>No potential sources of conflict of interest.</b></p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144299593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. L. Palomba, S. J. Schuster, R. Karmali, A. P. Skarbnik, J. S. Abramson, K. Ardeshna, P. Borchmann, B. T. Hill, A. M. Garcia-Sancho, A. Pinto, A. P. Rapoport, G. Cartron, I. Fleury, K. Izutsu, M. Kamdar, S. Mielke, A. M. Barbui, J. L. Reguera Ortega, L. J. Nastoupil, S. Ahmed, M. Bar, L. Diaz, V. Diab, M. Vedal, S. Colicino, A. Avilion, R. Nishii, F. Morschhauser
{"title":"LISOCABTAGENE MARALEUCEL (LISO-CEL) IN PATIENTS (PTS) WITH RELAPSED OR REFRACTORY (R/R) MARGINAL ZONE LYMPHOMA (MZL) IN THE PHASE 2 TRANSCEND FL STUDY","authors":"M. L. Palomba, S. J. Schuster, R. Karmali, A. P. Skarbnik, J. S. Abramson, K. Ardeshna, P. Borchmann, B. T. Hill, A. M. Garcia-Sancho, A. Pinto, A. P. Rapoport, G. Cartron, I. Fleury, K. Izutsu, M. Kamdar, S. Mielke, A. M. Barbui, J. L. Reguera Ortega, L. J. Nastoupil, S. Ahmed, M. Bar, L. Diaz, V. Diab, M. Vedal, S. Colicino, A. Avilion, R. Nishii, F. Morschhauser","doi":"10.1002/hon.70093_55","DOIUrl":"https://doi.org/10.1002/hon.70093_55","url":null,"abstract":"<p><b>Introduction:</b> There remains an unmet need for effective and safe treatment options for pts with R/R MZL. TRANSCEND FL (NCT04245839) is a global, phase 2, single-arm, multicohort study that evaluates the efficacy and safety of the anti-CD19 CAR T cell therapy, liso-cel, in pts with R/R FL or MZL. Here, we present the primary analysis in pts with R/R (third-line or later) MZL.</p><p><b>Methods:</b> Pts with R/R MZL who received ≥ 2 prior lines of systemic therapy, including a combination of an anti-CD20 antibody and an alkylating agent, or had relapsed disease after HSCT were eligible. Pts received liso-cel (100 × 10<sup>6</sup> CAR<sup>+</sup> T cells) after lymphodepleting chemotherapy (LDC). Bridging therapy was allowed, but reconfirmation of measurable disease was needed before LDC. The primary endpoint of ORR per independent review committee by CT using Lugano 2014 criteria (null hypothesis [H<sub>0</sub>]: ≤ 50%) and key secondary endpoint of CR rate (H<sub>0</sub>: ≤ 5%) were tested hierarchically.</p><p><b>Results:</b> At data cutoff, 77 pts were leukapheresed, 67 (87%) received liso-cel (safety set), and 66 (86%) were efficacy evaluable. Median (range) age was 62 y (37–81), 85% had Ann Arbor stage III/IV disease, 36% had progression of disease ≤ 24 mo of initiation of first-line immunochemotherapy, 39% had refractory disease, and 22% had bulky disease. MZL subtypes included nodal (48%), splenic (27%), and extranodal/mucosa-associated lymphoid tissue (25%). Median (range) prior lines of therapy was 3 (2–18). Median (range) on-study follow-up was 24.1 mo (1.1–43.0). The primary endpoint of ORR was met at 95.5% (95% CI: 87.3–99.1; 1-sided <i>p</i> < 0.0001; Table). The secondary endpoint of CR rate was also met at 62.1% (95% CI: 49.3–73.8; 1-sided <i>p</i> < 0.0001; Table). With a median follow-up of 21.6, 23.8, and 24.5 mo, respectively, the 24-mo rates were 88.6% for DOR (89.0% in pts with CR), 85.7% for PFS, and 90.4% for OS (Table).</p><p>All pts had any-grade (gr) treatment-emergent adverse events (TEAE; gr ≥ 3, 88%). Cytokine release syndrome (CRS) occurred in 76% of pts (gr 3, 4%; no gr 4–5) and neurological events (NE) in 33% (gr 3, 4%; no gr 4–5; Table). For CRS/NE management, 33% of pts received both tocilizumab and corticosteroids, 21% received tocilizumab only, and 6% received corticosteroids only. Prolonged cytopenia (gr ≥ 3 laboratory values at Day 29) occurred in 42% of pts (anemia, 9%; neutropenia, 27%; thrombocytopenia, 25%), gr ≥ 3 infection in 9%, and MAS-HLH in 4% (all gr 3 and resolved). Two grade 5 TEAEs occurred (1 on Day 32, pt had T-cell lymphoma [TCL]; 1 on Day 47, pt had neutropenic sepsis). Liso-cel transgene testing and integration site analysis suggested that the TCL was unrelated to liso-cel.</p><p><b>Conclusion:</b> In pts with R/R MZL, liso-cel demonstrated deep and durable responses with high survival rates at 24 mo. The safety profile of liso-cel was manageable, with low rates of gr 3 CRS/NE ","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_55","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144299721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Luminari, L. Conte, N. Shokun, M. Civallero, G. Hapgood, M. Prince, E. Miranda, C. Chiattone, M. E. Cabrera, A. Pavlovsky, F. Hits, T. Skrypets, S. M. Rodriguez Pinilla, F. Francine, R. Advani, J. Vose, M. Federico
{"title":"CLINICAL OUTCOMES AND PROGNOSTIC FACTORS IN NODAL AGGRESSIVE T-CELL LYMPHOMAS: INSIGHTS FROM 655 CASES REGISTERED IN THE T-CELL PROJECT 2.0","authors":"S. Luminari, L. Conte, N. Shokun, M. Civallero, G. Hapgood, M. Prince, E. Miranda, C. Chiattone, M. E. Cabrera, A. Pavlovsky, F. Hits, T. Skrypets, S. M. Rodriguez Pinilla, F. Francine, R. Advani, J. Vose, M. Federico","doi":"10.1002/hon.70094_388","DOIUrl":"https://doi.org/10.1002/hon.70094_388","url":null,"abstract":"<p>L. Conte, N. Shokun, M. Civallero, G. Hapgood, M. Prince, E. Miranda, C. Chiattone, M. E. Cabrera, A. Pavlovsky, F. Hits, T. Skrypets, S. M. Rodriguez Pinilla, F. Francine, R. Advani, and J. Vose equally contributing author.</p><p><b>Background:</b> According to the WHO classification of hematopoietic tissue tumors, the group of nodal aggressive T-cell lymphomas (TCLs) consists of PTCL-NOS, ALCL ALK-, AITL, and Nodal TCL with T-follicular helper phenotype. Despite advancements in therapeutic strategies, survival outcomes remain unfavorable. This study aims to evaluate the clinical characteristics, treatment patterns, and survival outcomes of patients diagnosed with nodal aggressive TCLs within the T-Cell Project 2.0, (clintrials.gov:03964480), an international prospective registry designed to improving the understanding of T-cell malignancies.</p><p><b>Methods:</b> A total of 655 patients diagnosed with nodal aggressive TCL between January 1, 2018, and June 30, 2023, were analyzed. Kaplan-Meier curves were used to estimate OS and PFS, while univariate and multivariate analyses identified prognostic factors.</p><p><b>Results:</b> The cohort included 312 patients with PTCL-NOS (47.6%), 172 with ALCL ALK- (26.3%), 158 with AITL (24.1%), and 13 with nodal TCL with TFH phenotype (1.9%). The median age was 60 yrs (19–93), with 59.7% males. The majority presented with stage III-IV (77.1%), 50.3% had B symptoms, 27.4% bone marrow involvement and 53.9% were EBV-positive.</p><p>The most frequent 1st line therapies were CHOEP (39.2%), CHOP/CHOP-like (30.8%) and BV-CHP. The CR rate was 49.0%, and PR 15.1%. Non-responders (NR) accounted for 35.9% of cases. The median follow-up was 26 months (95% CI: 22.4–29.6), with a 45.3% mortality rate.</p><p>The 2-yr OS and PFS rates were 50.8% and 36.1%, respectively. Patients achieving CR had significantly better survival outcomes, with a 2-yrs OS of 78.8% and PFS of 61.9%, while those with PR had a 2-yr OS of 34.8% and PFS of 21%. Of note, patients treated with BV-CHP showed a significantly better outcome (<i>p</i> < 0.001).</p><p>Univariate analysis identified age > 60 yrs (<i>p</i> < 0.001), stage III-IV (<i>p</i> < 0.001), ECOG ≥ 1 (<i>p</i> < 0.001), LDH > UNL (<i>p</i> < 0.001), hemoglobin < 12 g/dL (<i>p</i> < 0.001), platelets < 150 g/L (<i>p</i> < 0.001), albumin < 35 g/L (<i>p</i> = 0.01), histotype (ALCL- vs. PTCL-NOS or AITL: <i>p</i> < 0.001), IPI ≥ 2 (<i>p</i> < 0.001), and PIT ≥ 2 (<i>p</i> < 0.001) as significant negative prognostic factors for both OS and PFS.</p><p>In the multivariate analysis, histotype, age > 60 yrs, and stage III-IV emerged as independent prognostic factors for both OS and PFS (<i>p</i> < 0.001). Additionally, low PLT count was a significant independent predictor of worse PFS (<i>p</i> < 0.01).</p><p><b>Conclusions:</b> Nodal TCLs remain highly aggressive diseases with poor long-term survival. Patients with PCTL-NOS and AITL h","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Cheng, M. Cai, Z. Li, Y. Shuang, H. Wu, Q. Zhang, J. Ma, H. Zhou, Y. Li, K. Zhou, P. Li, W. Qian, W. Yang, S. Zhou, X. Jia, L. Jiao, J. Wangwu, X. Luo, C. Guan, D. Chen, S. Fan, M. M. Shi, W. Su, W. Zhao
{"title":"TAZEMETOSTAT PLUS AMDIZALISIB IN RELAPSED/REFRACTORY PERIPHERAL T-CELL LYMPHOMA PATIENTS WITH DIVERSE GENOMIC SIGNATURES: RESULTS FROM A PHASE 2 STUDY","authors":"S. Cheng, M. Cai, Z. Li, Y. Shuang, H. Wu, Q. Zhang, J. Ma, H. Zhou, Y. Li, K. Zhou, P. Li, W. Qian, W. Yang, S. Zhou, X. Jia, L. Jiao, J. Wangwu, X. Luo, C. Guan, D. Chen, S. Fan, M. M. Shi, W. Su, W. Zhao","doi":"10.1002/hon.70093_163","DOIUrl":"https://doi.org/10.1002/hon.70093_163","url":null,"abstract":"<p><b>Introduction:</b> Peripheral T-cell lymphomas (PTCL) are aggressive, heterogeneous T cell neoplasms lacking effective treatments. Patients (pts) with distinct gene signatures respond differently to therapies. Tazemetostat (TAZ) is the first enhancer-of-zeste-homolog-2 (EZH2) inhibitor approved by FDA in 2020. Amdizalisib is a novel and highly potent selective inhibitor of phosphatidylinositol 3-kinase p110δ isoform (PI3Kδ). This open label, single-arm, phase 2 trial (NCT05713110) evaluated the efficacy and safety of TAZ plus Amdizalisib in relapsed/refractory (R/R) lymphoma. Herein, we report the results in PTCL pts with genomic data.</p><p><b>Methods:</b> Pts with histologically confirmed R/R PTCL after at least one systemic therapy were eligible. TAZ 800 mg BID plus Amdizalisib 20 or 30 mg QD were administered orally until disease progression, intolerability, or withdrawal. The responses were assessed by investigators according to LUGANO 2014 criteria. Somatic gene alterations of tumor and blood samples were detected by next generation sequencing (NGS) (188-gene panel, Genetron).</p><p><b>Results:</b> Up to 31 Dec 2024, 29 PTCL pts were enrolled with median age of 61 years, 69.0% were male, 44.8% were stage IV and 20.7% with bone marrow involvement at baseline. Median prior systemic therapy lines were 3 (range 1–13), and 24 (82.8%) pts were refractory to the last regimen.</p><p>The overall response rate (ORR) was 60.7% (4 complete responses [CRs], 13 partial responses [PRs]) in 28 evaluable pts. The ORRs were 85.7% in angioimmunoblastic T cell lymphoma (AITL) (3 CRs, 9 PRs/14 evaluable pts), 25.0% in PTCL, not otherwise specified (2 PRs/8 evaluable pts), 100.0% in primary cutaneous anaplastic lymphoma kinase fusion-negative anaplastic large cell lymphoma (pcALK-ALCL) (1 CR, 1 PR/2 evaluable pts) and no response was observed in systemic ALK-ALCL pts (3 stable disease/3 evaluable pts). Median duration of response and progression-free survival were 6.47 and 8.25 months (m), respectively within a median follow-up of 10.97m. The overall survival has not been reached due to insufficient death events observed.</p><p>Genomic characteristics were assessed in 22 pts. <i>TET2</i> (55%) was the most prevalent mutation, followed by <i>PCLO</i> (32%), <i>HIST1H1E</i> (27%), <i>CSMD1</i> (23%), and <i>RHOA</i> (23%). ORR of 100% was observed in 5 pts with <i>TET2</i> and <i>RHOA</i> co-mutations. <i>CSMD1</i> and <i>RHOA</i> mutations were mutually exclusive. <i>CSMD1</i> alteration was associated with low ORR of 20%.</p><p>Median drug administration duration was 7.33m for 29 pts. Most pts (96.6%) experienced at least one treatment-related adverse event (TRAE), including 48.3% ≥ grade 3. The most common (> 10%) grade ≥ 3 TRAEs were neutropenia (24.1%), anaemia (17.2%), lymphopenia (13.8%), and thrombocytopenia (13.8%). No treatment-related death occurred.</p><p><b>Conclusions:</b> TAZ plus Amdizalisib has shown favorable responses in R/R PTCL, especi","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Belada, F. P. Gardner, A. C. de Oliveira, J. Sancho, E. Lomaia, D. Wright, M. Turgut, E. Martynova, Z. Lázár, B. Anz, M. Wang, W. Legiec, S. Opat, J. Pailden, H. M. Peltier, E. Marturano, J. P. Dean, I. W. Flinn
{"title":"IBRUTINIB-RITUXIMAB VERSUS PLACEBO-RITUXIMAB IN PATIENTS WITH PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA (FL): PRIMARY ANALYSIS OF THE PHASE 3 PERSPECTIVE STUDY","authors":"D. Belada, F. P. Gardner, A. C. de Oliveira, J. Sancho, E. Lomaia, D. Wright, M. Turgut, E. Martynova, Z. Lázár, B. Anz, M. Wang, W. Legiec, S. Opat, J. Pailden, H. M. Peltier, E. Marturano, J. P. Dean, I. W. Flinn","doi":"10.1002/hon.70093_26","DOIUrl":"https://doi.org/10.1002/hon.70093_26","url":null,"abstract":"<p><b>Introduction:</b> Single-agent rituximab (R) is indicated as first-line treatment for patients (pts) with FL who are ineligible for chemoimmunotherapy (CIT). In a phase 2 trial, ibrutinib (Ibr) plus R showed promising activity in pts with FL. Here, we report primary analysis results from the multinational, randomized, double-blind, phase 3 PERSPECTIVE study (NCT02947347) comparing Ibr-R versus placebo (Pbo) plus R in pts with previously untreated FL not eligible for CIT due to age and/or comorbidities.</p><p><b>Methods:</b> Eligible pts were ≥ 70 y, or 60–69 y with ≥ 1 comorbidity, and met ≥ 1 Groupe d'Etude des Lymphomes Folliculaires criterion for treatment. Pts were randomly assigned 3:1 to receive oral Ibr (560 mg) or Pbo once daily until progressive disease. All pts received R 375 mg/m<sup>2</sup> weekly for 4 wk then every 8 wk for up to 12 cycles. Randomization was stratified by age (60–69 years vs. ≥ 70 years), FLIPI-1 score (low vs. intermediate/high), and ECOG PS (0–1 vs. 2). The primary endpoint was progression-free survival (PFS) by investigator (INV) assessment per Cheson 2014 criteria using FDA censoring rules. PFS sensitivity analyses included PFS by independent review committee (IRC) assessment and use of global censoring rules. Secondary endpoints included overall response rate (ORR) by INV, overall survival (OS), infusion-related reaction (IRR) rates, and safety.</p><p><b>Results:</b> In total, 445 pts were assigned to receive Ibr-R (<i>n</i> = 334) or Pbo-R (<i>n</i> = 111). At baseline, median age was 74 y versus 75 y, 66% versus 67% had FLIPI-1 score ≥ 3, and 75% versus 76% had ECOG PS 0–1, respectively. At data cutoff, all pts had completed R treatment; Ibr or Pbo treatment was ongoing in 20% and 22% of pts, respectively. With a median time on study of 53.8 mo, PFS was significantly improved with Ibr-R versus Pbo-R (hazard ratio [HR], 0.71 [95% CI 0.53–0.96]; <i>p</i> = 0.02; median 42.0 vs. 32.8 mo) per INV with FDA censoring rules and with consistency in sensitivity analyses (Figure). ORR was 81% versus 68% with Ibr-R versus Pbo-R (rate ratio 1.19 [95% CI 1.04–1.36]; <i>p</i> = 0.004) and 4-y OS rates were 67% versus 71% (HR 1.12 [95% CI 0.77–1.63]; <i>p</i> = 0.55). IRRs occurred in 21% versus 27% of pts with Ibr-R versus Pbo-R. Median overall treatment duration was 22.1 mo with both Ibr-R and Pbo-R. Grade ≥ 3 AEs occurred in 78% versus 57% of pts; the most frequent grade ≥ 3 AEs were neutropenia (16% versus 7%), pneumonia (9% vs. 5%), hypertension (8% vs. 5%), COVID-19 (6% vs. 2%), COVID-19 pneumonia (6% vs. 3%), and diarrhea (6% vs. 2%); atrial fibrillation occurred in 5% versus 2%. Primary causes of death included AEs (14% vs. 7%) and FL (7% vs. 9%). 327 pts (73%) received study treatment during the pandemic; COVID-19-related death occurred in 9% of pts in the Ibr-R arm and 7% in the Pbo-R arm.</p><p><b>Conclusions:</b> In pts with previously untreated FL for whom R monotherapy is appropriate, addition of Ibr led","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Höfmann, A. Tabatabai, R. Flümann, S. Klein, I. Kisis, R. Öllinger, M. Möllmann, M. Hartnack, S. Kesper, A. Arora, B. v. Tresckow, R. D. Jachimowicz, R. Rad, G. Knittel, H. C. Reinhardt
{"title":"AN IN VIVO PIGGYBAC INSERTIONAL MUTAGENESIS SCREEN TO SEARCH FOR MODIFIERS OF Myd88L265P-DRIVEN DLBCL LYMPHOMAGENESIS","authors":"S. Höfmann, A. Tabatabai, R. Flümann, S. Klein, I. Kisis, R. Öllinger, M. Möllmann, M. Hartnack, S. Kesper, A. Arora, B. v. Tresckow, R. D. Jachimowicz, R. Rad, G. Knittel, H. C. Reinhardt","doi":"10.1002/hon.70094_186","DOIUrl":"https://doi.org/10.1002/hon.70094_186","url":null,"abstract":"<p><b>Introduction:</b> Based on genetic features, human DLBCL cases can be subdivided into several distinct clusters. Recurrent mutations in <i>MYD88</i>, <i>CD79B</i>, <i>PRDM1</i> and frequent <i>BCL2</i> copy number gains are characteristic of the MCD/C5 cluster. Mice with B cell-specific expression of <i>Myd88</i><sup><i>L252P</i></sup> (orthologous to human p.L265P) develop a lymphoproliferative phenotype at old age and occasional lymphoma. We aimed to identify genes cooperating with <i>Myd88</i><sup><i>p.L252P</i></sup> in DLBCL lymphomagenesis by performing an <i>in vivo piggyBac</i> (<i>PB</i>) insertional mutagenesis screen.</p><p><b>Methods:</b> We crossed the <i>PB</i> transposon system with the <i>Myd88</i><sup><i>cond_p.L252P</i></sup> allele. Both the <i>PB</i> system and expression of <i>Myd88</i> p.L252P were activated B cell-specifically with <i>Cd19</i><sup><i>Cre</i></sup>. Animals were aged and samples were collected when mice became moribund. The isolated tumors were characterized immunohistochemically and transcriptionally. The malignant nature was verified by B cell receptor clonality analysis. Lastly, common transposon integrations were identified by QiSeq and subsequent bioinformatic analysis.</p><p>One of the most prominent hits from this screen was <i>Etv6</i>, which is commonly affected by deleterious mutations in MCD/C5 DLBCL. To investigate the role of <i>ETV6</i> in B cell biology and lymphomagenesis, we utilized an <i>Etv6-</i>flox allele in combination with <i>Cd19</i><sup><i>Cre/wt</i></sup>. Changes in the B cell compartment were determined by flow cytometry in steady state and after immunization. Cohorts were aged and developing lesions were characterized histologically and transcriptionally.</p><p><b>Results:</b> The presence of the <i>PB</i> system on the <i>Myd88</i><sup><i>L252P</i></sup> background reduced overall survival. <i>Myd88</i>/<i>PB</i> mice formed clonal B220<sup>+</sup> lymphomas. We were able to identify ∼1000 genes with significantly enriched integrations. Reminiscent of MCD DLBCL, hits were strongly enriched for the KEGG gene set ‘B cell receptor signaling’. Furthermore, we observed a distinct overlap between the <i>PB</i> hits and genes mutated in MCD DLBCL, including <i>Tbl1xr1</i>, <i>Pim1</i> and <i>Etv6</i>. To investigate the effects of a B cell-specific loss of <i>Etv6</i>, we crossed a conditional knockout-allele to <i>Cd19</i><sup><i>Cre</i></sup>. Germinal center (GC) B cells were increased in 30wks old unimmunized <i>Etv6</i>-KO animals compared to <i>Cd19</i><sup><i>Cre</i></sup> controls. In contrast, post-GC species were reduced in <i>Etv6</i>-KO. Unexpectedly, the number of NP-specific GCB cells was lower in the <i>Etv6</i>-KO cohort ten days after NP-OVA immunization. To assess the lymphomagenic potential of <i>Etv6</i> loss in a <i>Myd88</i>-mutant setting, we generated <i>Myd88</i><sup><i>p.L252P</i></sup> animals with or without <i>Etv6</i>-KO. Indeed, <i>Etv6</i>-KO resu","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"MOLECULAR FEATURES ENCODED IN THE DYNAMIC ctDNA MONITORING REVEAL PROGNOSTIC VALUE, DIFFERENT CLINICAL COURSES AND CLONE EVOLUTION FOR DIFFERENT GENETIC SUBTYPES OF DLBCL","authors":"J. Liang, Y. Wu, W. Xu","doi":"10.1002/hon.70094_422","DOIUrl":"https://doi.org/10.1002/hon.70094_422","url":null,"abstract":"<p><b>Introduction:</b> The ctDNA-based minimal residual disease (MRD) status at the end of treatment (MRD<sup>end</sup>) has been demonstrated as even stronger prognostic marker in both clinical trial and the real-world population for DLBCL patients (pts). However, no data has been shown (i) The clinical course embedded in the different genetic subtypes of DLBCL, (ii) Clonal evolution possessed in serial tissue and plasma samples.</p><p><b>Methods:</b> We enrolled 164 DLBCL pts from our center undergoing first line (1L) therapy for ctDNA profiling at 2 pre-defined milestones (matched baseline and end of treatment (EOT) plasma samples) using a 475 gene lymphoma-specific sequencing panel which had been detailed decribed in our previous work (<i>Jinhua Liang, Leukemia</i>). By the last visit in December 2024, the median follow-up duration was 25.4 (range, 14.9−43.7) months. All pts received R-CHOP regimens.</p><p><b>Results:</b> Among the 164 pts, the median age was 57 years, 57.3% had stage III−IV disease and 42.1% had IPI scores 3−5. Among the 164 pts, 46 pts (28.1%) were defined as MRD<sup>end</sup> positivity (MRD<sup>end+</sup>) (Figure 1A). The LymphGen subtype classification according to plasma and tissue were shown in Figure 1B. The MRD<sup>end− </sup>ratio in different genetype was shown in Figure 1C. EOT-MRD status is associated with worse PFS and OS (<i>p</i> < 0.001). Among the EOT-CR patients (<i>N</i> = 131), MRD<sup>end+</sup> pts had trend towards worse PFS (<i>p</i> = 0.069) (Figure 1D-E). After analyzing the disease course of all pts according to the genetic subtypes, we found that the clinical problem for TP53 disruption pts is primary refractory, rather than relapse. However, MCD subtype that has poor prognosis because of a persistent high risk of relapse despite reaching CR while the clinical problem for BN2 pts is primary refractory and high rate of relapse (Figure 1F). MRD<sup>end</sup> negativity was unstable and prone to relapse for BN2 and MCD subtype patients (Figure 1G<b>)</b>. The EOT top gene alterations (GAs) for MRD<sup>end+</sup> pts was TP53<sup>mut</sup> (34.8%) which were significantly different from baseline plasma mutation profiling (Figure 1H). Firstly, we found that most EOT GAs for the MRD<sup>end+</sup> pts were the predominant gene at baseline according the serial plasma samples (Figure 1I). However, 37 pts had additional GAs (Figure 1J) which were enriched in cell differentiation, cell cycle and TP53 disruption pathways (Figure 1L) in PD plasma samples in comparison with pretreatment plasma samples and the detailed number were shown in Figure 1K. Among the 38 pts of TP53<sup>mut</sup>, 18 pts were MRD<sup>end+ </sup>(47.4%); among these 18 MRD<sup>end+</sup> pts, TP53<sup>mut</sup> was not cleared in 11 pts (61.1%) (Figure 1M). </p><p><b>Conclusions:</b> These data demonstrate that: (i) Different clinical courses were shown in different genetic subtypes for further personalized subtype-specific clinica","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Gowdy, J. Flerlage, J. Seelisch, M. Palese, T. Bradshaw, S. M. Castellino, S. Cho, K. Dieckmann, B. S. Hoppe, S. Howard, K. Kelly, L. Kurch, H. Lai, E. Lopci, J. Lucas, C. Mauz-Körholz, K. McCarten, N. Pandit-Taskar, H. Schöder, J. Steglich, D. Stoevesandt, S. Voss, S. Milgrom
{"title":"PROGNOSTIC VALUE OF 18F-FDG PET/CT VOLUMETRIC PARAMETERS IN CHILDHOOD, ADOLESCENT, AND YOUNG ADULT HODGKIN LYMPHOMA: A SYSTEMATIC REVIEW FROM THE SEARCH GROUP","authors":"C. Gowdy, J. Flerlage, J. Seelisch, M. Palese, T. Bradshaw, S. M. Castellino, S. Cho, K. Dieckmann, B. S. Hoppe, S. Howard, K. Kelly, L. Kurch, H. Lai, E. Lopci, J. Lucas, C. Mauz-Körholz, K. McCarten, N. Pandit-Taskar, H. Schöder, J. Steglich, D. Stoevesandt, S. Voss, S. Milgrom","doi":"10.1002/hon.70094_373","DOIUrl":"https://doi.org/10.1002/hon.70094_373","url":null,"abstract":"<p>C. Gowdy, J. Flerlage, J. Seelisch, M. Palese, T. Bradshaw, S. M. Castellino, S. Cho, K. Dieckmann, B. S. Hoppe, S. Howard, K. Kelly, L. Kurch, H. Lai, E. Lopci, J. Lucas, C. Mauz-Körholz, K. McCarten, N. Pandit-Taskar, H. Schöder, J. Steglich, D. Stoevesandt, and S. Voss equally contributing author.</p><p><b>Introduction:</b> In adults with classic Hodgkin lymphoma (cHL), PET volumetric parameters, such as metabolic tumor volume (MTV), are valuable for risk stratification. This study was undertaken to explore the role of metabolic parameters in children, adolescents, and young adults with cHL.</p><p><b>Methods:</b> This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Five databases were searched on 16th October 2024: MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), EBM Reviews (OVID) and the Web of Science Core Collection. Eligible studies were peer-reviewed manuscripts, written in English, published from database inception to the search date that included patients up to 21 years of age with a diagnosis of cHL and a <sup>18</sup>F-FDG PET/CT scan with calculation of MTV. Two authors independently reviewed all studies identified in the literature search.</p><p><b>Results:</b> The search strategy detected 3669 studies from which 1085 duplicates and 2584 studies were excluded following 2-person review of titles and abstracts. Full-text review of 81 papers identified 35 as eligible for inclusion. Fifteen of the papers (43%) evaluated a cohort exclusively < 21 years of age and 20 papers (57%) considered children and adults, with a median of 69 (21–297) participants. All 8 studies that explored the association of baseline MTV and/or TLG (total lesion glycolysis) with known risk factors (ex. bulk, stage, clinical parameters used to define treatment group/level) identified a significant correlation. Twelve papers explored the association of baseline MTV and/or TLG with disease response on PET/CT according to Lugano criteria, of which 9 (75%) demonstrated a statistically significant correlation. Twenty papers explored the association of baseline PET parameters with clinical outcome (ex. overall survival, progression-free survival) and 15 (75%) demonstrated an independent statistically significant correlation. Of 6 studies that explored higher-order radiomic features, 4 (67%) found that they out-performed MTV and/or TLG. Thirty-three of 35 studies detailed the segmentation approach that was used to delineate disease, of which 11 used or recommended an absolute fixed threshold method.</p><p><b>Conclusions:</b> Metabolic PET parameters are valuable for risk stratification; the review has found heterogeneity of results related to differences in patient cohorts, treatment strategies, methods for disease segmentation, and parameter calculation. This group of international experts will provide recommendations regarding the necessary next steps to harmonize the approach and ","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70094_373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144292478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}