Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Leuk Lymphoma. 2022 Jan;63(1):74-83. doi: 10.1080/10428194.2021.1971223. Epub 2021 Aug 26.
Many patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) will not respond to platinum-containing salvage chemotherapy. Predicting treatment failure earlier could help clinicians minimize chemotherapy toxicities for non-responders in favor of other treatments. We conducted a pilot study where 2 early PET/CTs were obtained on days 4 (D4) and 21 (D21) of cycle 1 (C1) of salvage therapy for DLBCL. Twenty-five patients were enrolled and have evaluable data. Ten (40%) had an unplanned therapy change after C1 and before end-of-treatment (EOT) evaluation due to treatment failure on early PET/CT as interpreted by the treating physician. Early PET/CT response at D4 or D21 was not associated with EOT response in evaluable patients. Disease specific survival was longer for patients with a persistent response on both D4 and D21 ( = 0.042). Early PET/CT may predict salvage chemotherapy failure and could inform future clinical trials investigating early therapy change to non-chemotherapy treatments.
许多复发或难治性弥漫性大 B 细胞淋巴瘤（DLBCL）患者对含铂挽救性化疗无反应。更早地预测治疗失败可以帮助临床医生为非应答者减少化疗毒性，转而采用其他治疗方法。我们进行了一项试点研究，在挽救性治疗 DLBCL 的第 1 周期（C1）的第 4 天（D4）和第 21 天（D21）获得了 2 次早期 PET/CT。共纳入 25 例有可评估数据的患者。由于治疗医生根据早期 PET/CT 解读为治疗失败，10 例（40%）在 C1 后和治疗结束（EOT）评估前计划外更改了治疗方案。在可评估患者中，D4 或 D21 的早期 PET/CT 反应与 EOT 反应无关。在 D4 和 D21 均持续应答的患者中，疾病特异性生存时间更长（ = 0.042）。早期 PET/CT 可能预测挽救性化疗失败，并为未来探索早期改变非化疗治疗的临床试验提供信息。
