The prognostic role of post-induction FDG-PET in patients with follicular lymphoma: A subset analysis from the FOLL05 trial of the Fondazione Italiana Linfomi (FIL)

Stefano Luminari, I. Biasoli, A. Versari, S. Rattotti, C. Bottelli, C. Rusconi, F. Merli, M. Spina, A. J M Ferreri, P. L. Zinzani, A. Gallamini, A. Franceschetto, C. Boccomini, S. Franceschetti, F. Salvi, F. D. Raimondo, A. M. Carella, Q. Micol, M. Balzarotti, P. MustoM. Federico

Research output: Contribution to journalArticlepeer-review

Abstract

Background: [18F]fluorodeoxyglucose-positron emission tomography (PET) is emerging as a strong diagnostic and prognostic tool in follicular lymphoma (FL) patients. Patients and methods: In a subset analysis of the FOLL05 trial (NCT00774826), we investigated the prognostic role of post-induction PET (PI-PET) scan. Patients were eligible to this study if they had a PI-PET scan carried out within 3 months from the end of induction immunochemotherapy. Progression-free survival (PFS) was the primary study end point. Results: A total of 202 patients were eligible and analysed for this study. The median age was 55 years (range 33-75). Overall, PI-PET was defined as positive in 49 (24%) patients. Conventional response assessment with CT scan was substantially modified by PET: 15% (22/145) of patients considered as having a complete response (CR) after CT were considered as having partial response (PR) after PI-PET and 53% (30/57) patients considered as having a PR after CT were considered as a CR after PI-PET. With a median follow-up of 34 months, the 3-year PFS was 66% and 35%, respectively, for patients with negative and positive PI-PET (P <0.001). At multivariate analysis, PI-PET (hazard ratio 2.57, 95% confidence interval 1.52-4.34, P <0.001) was independent of conventional response, FLIPI and treatment arm. Also, the prognostic role of PI-PET was maintained within each FLIPI risk group. Conclusions: In FL patients, PI-PET substantially modifies response assessment and is strongly predictive for the risk of progression. PET should be considered in further updates of response criteria.

Original languageEnglish
Article numbermdt562
Pages (from-to)442-447
Number of pages6
JournalAnnals of Oncology
Volume25
Issue number2
DOIs
Publication statusPublished - 2014

Keywords

  • FDG-PET
  • Follicular lymphoma
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)

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