PMID- 37453865
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231102
IS  - 2152-2669 (Electronic)
IS  - 2152-2669 (Linking)
VI  - 23
IP  - 10
DP  - 2023 Oct
TI  - Imaging Biomarkers to Predict Outcomes in Patients With Large B-Cell Lymphoma 
      With a Day 28 Partial Response by (18)F-FDG PET/CT Imaging Following CAR-T 
      Therapy.
PG  - 757-763
LID - S2152-2650(23)00187-8 [pii]
LID - 10.1016/j.clml.2023.06.005 [doi]
AB  - CD19 directed CAR-T therapy for Large B-cell lymphoma (LBCL) has shown great 
      therapeutic response in patients with relapsed/refractory disease with response 
      rates of 60-80%. However, in patients with a partial response (PR) on initial day 
      28 post CAR-T therapy imaging, clinical uncertainty remains as half of these 
      patients will ultimately have relapsed disease.   PATIENTS: In 24 patients 
      receiving CD19 directed CAR-T therapy for relapsed/refractory LBCL achieving a PR 
      on day 28, we utilize imaging biomarkers by 18F-FDG PET/CT imaging at pre CAR-T 
      therapy baseline and day 28 to determine factors that may predict best overall 
      response (B-OR), progression free survival (PFS), and overall survival (OS).   
      METHODS: Out of 75 patients receiving CAR-T therapy at a single institution, we 
      retrospectively identified and reviewed 25 (33%) as achieving a PR on day 28. PR 
      was defined using the 2014 Lugano classification system. All patients received 
      standard of care CD19 directed CAR-T therapy with axicabtagene ciloleucel. Two 
      independent nuclear medicine physicians measured baseline (pre-CAR-T therapy) and 
      day 28 PET/CT SUVmax, SUVmean and TMV (cm3) of each lesion (node, organ or marrow 
      uptake, if any) using ROVER software. All statistical tests were two-sided and 
      conducted at the 0.05 level of significance. R version 1.3.1099 (R-studio) was 
      used for statistical modeling.   CONCLUSION: We demonstrate that a higher day 28 
      SUVmax was significantly higher in those with a B-OR of PR and in our modeling, a 
      lower day 28 SUVmax may predict favorable PFS and OS. Additionally, lower TMV, 
      both at baseline and day 28, may also be predictive of longer PFS and OS, while 
      lower TLG at baseline, but not day 28 is significantly associated with a B-OR of 
      CR. While further study is warranted, these imaging biomarkers may allow for 
      early identification of those with a day 28 PR at highest risk for relapse 
      leading to early intervention to improve long term outcomes.
CI  - Copyright (c) 2023 The Author(s). Published by Elsevier Inc. All rights reserved.
FAU - Lutfi, Forat
AU  - Lutfi F
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States; Division of Hematologic Malignancies and 
      Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, 
      United States. Electronic address: flutfi@kumc.edu.
FAU - Goloubeva, Olga
AU  - Goloubeva O
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Kowatli, Amer
AU  - Kowatli A
AD  - Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland 
      Medical Center, Baltimore, MD, United States.
FAU - Gryaznov, Anton
AU  - Gryaznov A
AD  - Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland 
      Medical Center, Baltimore, MD, United States.
FAU - Kim, Dong W
AU  - Kim DW
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Dureja, Rohan
AU  - Dureja R
AD  - Stanford Medicine, Stanford, CA, United States.
FAU - Margiotta, Philip
AU  - Margiotta P
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Matsumoto, Lisa R
AU  - Matsumoto LR
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Bukhari, Ali
AU  - Bukhari A
AD  - Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland 
      Medical Center, Baltimore, MD, United States.
FAU - Ahmed, Nausheen
AU  - Ahmed N
AD  - Division of Hematologic Malignancies and Cellular Therapeutics, University of 
      Kansas Medical Center, Kansas City, KS, United States.
FAU - Mushtaq, Muhammad Umair
AU  - Mushtaq MU
AD  - Division of Hematologic Malignancies and Cellular Therapeutics, University of 
      Kansas Medical Center, Kansas City, KS, United States.
FAU - Law, Jennie Y
AU  - Law JY
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Lee, Seung T
AU  - Lee ST
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Kocoglu, Mehmet H
AU  - Kocoglu MH
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Atanackovic, Djordje
AU  - Atanackovic D
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Yared, Jean A
AU  - Yared JA
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Hardy, Nancy M
AU  - Hardy NM
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - McGuirk, Joseph P
AU  - McGuirk JP
AD  - Division of Hematologic Malignancies and Cellular Therapeutics, University of 
      Kansas Medical Center, Kansas City, KS, United States.
FAU - Rapoport, Aaron P
AU  - Rapoport AP
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
FAU - Chen, Wengen
AU  - Chen W
AD  - Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland 
      Medical Center, Baltimore, MD, United States.
FAU - Dahiya, Saurabh
AU  - Dahiya S
AD  - University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer 
      Center, Baltimore, MD, United States.
LA  - eng
PT  - Journal Article
DEP - 20230619
PL  - United States
TA  - Clin Lymphoma Myeloma Leuk
JT  - Clinical lymphoma, myeloma & leukemia
JID - 101525386
RN  - 0 (Receptors, Chimeric Antigen)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
RN  - 0 (Biomarkers)
RN  - 0 (Antigens, CD19)
SB  - IM
MH  - Humans
MH  - *Receptors, Chimeric Antigen/therapeutic use
MH  - Positron Emission Tomography Computed Tomography/methods
MH  - Fluorodeoxyglucose F18/therapeutic use
MH  - Retrospective Studies
MH  - Clinical Decision-Making
MH  - Neoplasm Recurrence, Local/drug therapy
MH  - Uncertainty
MH  - Immunotherapy, Adoptive/adverse effects
MH  - *Lymphoma, Large B-Cell, Diffuse/therapy/drug therapy
MH  - Biomarkers
MH  - Antigens, CD19
EDAT- 2023/07/16 01:06
MHDA- 2023/10/23 00:42
CRDT- 2023/07/15 22:00
PHST- 2023/02/05 00:00 [received]
PHST- 2023/06/03 00:00 [revised]
PHST- 2023/06/11 00:00 [accepted]
PHST- 2023/10/23 00:42 [medline]
PHST- 2023/07/16 01:06 [pubmed]
PHST- 2023/07/15 22:00 [entrez]
AID - S2152-2650(23)00187-8 [pii]
AID - 10.1016/j.clml.2023.06.005 [doi]
PST - ppublish
SO  - Clin Lymphoma Myeloma Leuk. 2023 Oct;23(10):757-763. doi: 
      10.1016/j.clml.2023.06.005. Epub 2023 Jun 19.