Ceriani poster B7 Mentone 2012 - International Workshop on PET in
RESULTS OF THE IELSG-26 STUDY. L. Ceriani *, M. Martelli, P.L. Zinzani, S. Govi, C. Stelitano, U. Vitolo,. E. Brusamolino, G. Cabras,L. Rigacci, M. Balzarotti, ...
PET/CT RESPONSE ANALYSIS IN PRIMARY MEDIASTINAL DIFFUSE LARGE B-CELL LYMPHOMA (PMLBCL): RESULTS OF THE IELSG-26 STUDY L. Ceriani *, M. Martelli, P.L. Zinzani, S. Govi, C. Stelitano, U. Vitolo, E. Brusamolino, G. Cabras,L. Rigacci, M. Balzarotti, F. Salvi , S. Montoto, A. Lopez-Guillermo, E. Zucca, L. Giovanella and P.W.M. Johnson
*
Department of Nuclear Medicine and PET/CT Centre Oncology Institute of Southern Switzerland (IOSI) - Bellinzona (CH) On behalf of
the International Extranodal Lymphoma Study Group (IELSG), the Fondazione Italiana Linfomi (FIL) and the UK NCRI Lymphoma Group
IELSG-26 study: AIM
The IELSG-26 study was designed to prospectively evaluate the clinical role of PET/CT after rituximab and anthracycline-containing immunochemotherapy (R-CHT) in patients with PMLBCL.
26
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study on the PET/CT response after R-chemotherapy in primary mediastinal (thymic) large B-cell lymphoma (PMLBCL) 125 PMLBCL enrolled
Baseline PET (within 14 days before R-Chemo) Interim PET suggested, not mandatory after half of planned R-Chemo
Full course of chemotherapy: R-CHOP 21 or R-CHOP 14 or R-MACOP-B or R-VACOP-B
Final PET
Actually given to 92% of patients
(3-4 weeks after R-Chemo) Post-RT PET at least 2 months after RT
26
Consolidation RT
Follow-up
(according to local policy)
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study: PET/CT response Criteria for final PET (at 3-4 weeks after R-Chemotherapy)
*
IHP criteria (Juweid et al. JCO 2007) Negative final PET : no residual uptake or minimal residual uptake ≤ MBP
No uptake. Uptake ≤ mediastinum. Uptake > mediastinum but ≤ liver. Uptake moderately more than liver uptake, at any site. Markedly increased uptake at any site and new disease sites
1
2 negative
26
3
4
5
positive
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study: Preliminary results Post R-chemo PET interpretation - blind central review 115 /125 studies reviewed 115 PET/CT
47% 54 PET -
61 PET +
(95% CI 36-58)
53% (95% CI 42-64)
1
2
3
4
5
Nr. of patients
12
42
27
24
10
PD or relapse
-
1
-
4
5
Deauville score
median F.U. 34 months
negative
26
positive
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study: Preliminary results
26
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study: Preliminary results
26
INTERNATIONAL EXTRANODAL LYMPHOMA STUDY GROUP
IELSG-26 study: preliminary conclusions 1. with the MBP cut-point, the PET+ rate (Deauville score>2) after R-Chemo in PMLBCL was higher (53%) than in DLBCL or HL
2. >90% of pts are projected to be alive and progression-free at 5 years post treatment and a negative PET/CT after R-Chemo is significantly associated with a longer PFS.
3. pts with Deauville score 3 had a clinical outcome identical to those with score 1-2, suggesting that the liver uptake may represent a more appropriate cut-point for the definition of CR.
4. Pts with score 4 and 5 had a significantly worse PFS and OS 5. a negative PET after R-CHT may select a subgroup of patients who may not need consolidation RT (IELSG 37 study is ongoing)
3rd International Workshop on Interim PET in Lymphoma. Menton, September 27, 2011. Poster Discussion. Poster discussion. NHL. Ulrich Dührsen. Department ...
A 110 - Mounier N, Bower M, Spina M, Besson C, Schiantarelli C, Re A Bonnet F ..... Medicine Unit, Ospedale Policlinico, Padova; (7) Nuclear Medicine Unit, Ospedale La ...... Results: The average (median) time per scan upload and download.
Oct 5, 2012 - MTV0 (⤠225 vs > 225) was predictive of 3-year progression free survival (3y-. PFS) (85% vs 42%; ...... Among 33 CSI/II pts, 21 (64%) actually ..... The average (median) time per scan upload and download were 13'23â (3'06â).
Staging and risk assessment of marginal zone lymphoma: ââ¦The value of positron emission ... MALT originating from the left lacrimal gland. PET-CT in MALT ...
published in Leukemia Lymphoma. ⢠Would the next step be :Imaging in ... lymphoma subtypes (FL,MCL,T-lymphoma ). 3. Identify key area of research in ...
if + (scores 4-5) or equivocal (score 3) then PET after 2 ABVD cycle. ⢠N=199 HL. 54 I-IIA .... Baseline MTV predictive of PFS and OS although tumor bulk was not.
FDG-PET after 2 cycles appears highly predictive, particularly for ... features (bulk, 3+ sites). ⢠All prognostic ... Assumptions: â 75% PET-negative after 2 ABVD.
Apr 9, 2010 - Haematology Torino and Rome. Second International workshop ... >No concomitant cardiac, liver, lung or renal disease. >HIV negativity, HCV ...
background activity to define PET positivity for a residual mass 2 cm in greatest transverse ... Volumetric analysis of tumour bulk and total tumour burden.
Apr 8, 2010 - Positivity/Reference background. â¢Nearby background. â¢Mediastinal blood pool ... On which curve is this patient? Significance of minimal ...
Therapy ABVD or EBVD x 6 ± consolidation or IF radiotherapy. Visual assessment: ... LYMPHOMA. 44 HIV-related HL patients enrolled in 9 European centers.
The five-point visual assessment is applied as proposed at the Deauville consensus meeting. ⢠A cohort of ABVD-treated advanced-stage HL patients has been ...
