We tested baseline positron emission tomography (PET)/computed tomography (CT) as a measure of total tumor burden to better identify high-risk patients with early-stage Hodgkin lymphoma (HL). Patients with stage I-II HL enrolled in the standard arm (combined modality treatment) of the H10 trial (NCT00433433) with available baseline PET and interim PET (iPET2) after 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine were included. Total metabolic tumor volume (TMTV) was measured on baseline PET. iPET2 findings were reported negative (DS1-3) or positive (DS4-5) with the Deauville scale (DS). The prognostic value of TMTV was evaluated and compared with baseline characteristics, staging classifications, and iPET2. A total of 258 patients were eligible: 101 favorable and 157 unfavorable. The median follow-up was 55 months, with 27 progression-free survival (PFS) and 12 overall survival (OS) events. TMTV was a prognosticator of PFS (P < .0001) and OS (P 5 .0001), with 86% and 84% specificity, respectively. Five-year PFS and OS were 71% and 83% in the high-TMTV (>147 cm3) group (n 5 46), respectively, vs 92% and 98% in the low-TMTV group (£147 cm3). In multivariable analysis including iPET2, TMTV was the only baseline prognosticator compared with the current staging systems proposed by the European Organization for Research and Treatment of Cancer/Groupe d’Etude des Lymphomes de l’Adulte, German Hodgkin Study Group, or National Comprehensive Cancer Network. TMTV and iPET2 were independently prognostic and, combined, identified 4 risk groups: low (TMTV£1471DS1-3; 5-year PFS, 95%), low-intermediate (TMTV>1471DS1-3; 5-year PFS, 81.6%), high-intermediate (TMTV£1471DS4-5; 5-year PFS, 50%), and high (TMTV>1471DS4-5; 5-year PFS, 25%). TMTV improves baseline risk stratification of patients with early-stage HL compared with current staging systems and the predictive value of early PET response as well. (Blood. 2018;131(13):1456-1463)

Prognostic value of baseline metabolic tumor volume in early-stage Hodgkin lymphoma in the standard arm of the H10 trial / Cottereau, Anne-Ségolène; Versari, Annibale; Loft, Annika; Casasnovas, Olivier; Bellei, Monica; Ricci, Romain; Bardet, Stéphane; Castagnoli, Antonio; Brice, Pauline; Raemaekers, John; Deau, Bénédicte; Fortpied, Catherine; Raveloarivahy, Tiana; Van Zele, Emelie; Chartier, Loic; Borght, Thierry Vander; Federico, Massimo; Hutchings, Martin; Ricardi, Umberto; Andre, Marc; Meignan, Michel. - In: BLOOD. - ISSN 0006-4971. - 131:13(2018), pp. 1456-1463. [10.1182/blood-2017-07-795476]

Prognostic value of baseline metabolic tumor volume in early-stage Hodgkin lymphoma in the standard arm of the H10 trial

Bellei, Monica;Federico, Massimo;
2018

Abstract

We tested baseline positron emission tomography (PET)/computed tomography (CT) as a measure of total tumor burden to better identify high-risk patients with early-stage Hodgkin lymphoma (HL). Patients with stage I-II HL enrolled in the standard arm (combined modality treatment) of the H10 trial (NCT00433433) with available baseline PET and interim PET (iPET2) after 2 cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine were included. Total metabolic tumor volume (TMTV) was measured on baseline PET. iPET2 findings were reported negative (DS1-3) or positive (DS4-5) with the Deauville scale (DS). The prognostic value of TMTV was evaluated and compared with baseline characteristics, staging classifications, and iPET2. A total of 258 patients were eligible: 101 favorable and 157 unfavorable. The median follow-up was 55 months, with 27 progression-free survival (PFS) and 12 overall survival (OS) events. TMTV was a prognosticator of PFS (P < .0001) and OS (P 5 .0001), with 86% and 84% specificity, respectively. Five-year PFS and OS were 71% and 83% in the high-TMTV (>147 cm3) group (n 5 46), respectively, vs 92% and 98% in the low-TMTV group (£147 cm3). In multivariable analysis including iPET2, TMTV was the only baseline prognosticator compared with the current staging systems proposed by the European Organization for Research and Treatment of Cancer/Groupe d’Etude des Lymphomes de l’Adulte, German Hodgkin Study Group, or National Comprehensive Cancer Network. TMTV and iPET2 were independently prognostic and, combined, identified 4 risk groups: low (TMTV£1471DS1-3; 5-year PFS, 95%), low-intermediate (TMTV>1471DS1-3; 5-year PFS, 81.6%), high-intermediate (TMTV£1471DS4-5; 5-year PFS, 50%), and high (TMTV>1471DS4-5; 5-year PFS, 25%). TMTV improves baseline risk stratification of patients with early-stage HL compared with current staging systems and the predictive value of early PET response as well. (Blood. 2018;131(13):1456-1463)
2018
1-feb-2018
131
13
1456
1463
Prognostic value of baseline metabolic tumor volume in early-stage Hodgkin lymphoma in the standard arm of the H10 trial / Cottereau, Anne-Ségolène; Versari, Annibale; Loft, Annika; Casasnovas, Olivier; Bellei, Monica; Ricci, Romain; Bardet, Stéphane; Castagnoli, Antonio; Brice, Pauline; Raemaekers, John; Deau, Bénédicte; Fortpied, Catherine; Raveloarivahy, Tiana; Van Zele, Emelie; Chartier, Loic; Borght, Thierry Vander; Federico, Massimo; Hutchings, Martin; Ricardi, Umberto; Andre, Marc; Meignan, Michel. - In: BLOOD. - ISSN 0006-4971. - 131:13(2018), pp. 1456-1463. [10.1182/blood-2017-07-795476]
Cottereau, Anne-Ségolène; Versari, Annibale; Loft, Annika; Casasnovas, Olivier; Bellei, Monica; Ricci, Romain; Bardet, Stéphane; Castagnoli, Antonio; Brice, Pauline; Raemaekers, John; Deau, Bénédicte; Fortpied, Catherine; Raveloarivahy, Tiana; Van Zele, Emelie; Chartier, Loic; Borght, Thierry Vander; Federico, Massimo; Hutchings, Martin; Ricardi, Umberto; Andre, Marc; Meignan, Michel
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1166016
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