To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: FDG-PET Useful in Tailoring Therapy for Patients With Advanced Hodgkin's Lymphoma: Presented at EHA URL: http://www.pslgroup.com/dg/2238DE.htm Doctor's Guide June 15, 2008
By Emma Hitt, PhD COPENHAGEN, Denmark -- June 15, 2008 -- Positron emission tomography (PET) may be useful in predicting treatment failure in chemotherapy-treated patients with Hodgkin's lymphoma (HL) and, therefore, may help identify which patients can be spared aggressive treatment and which are likely to benefit, new findings suggest. Andrea Gallamini, MD, Department of Haematology, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy, presented the study here on June 14 at the 13th Congress of the European Haematology Association (EHA). Treatment of HL with 6 courses of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy induces disease remission in about 75% of patients with HL. More aggressive therapy has demonstrated an even greater efficacy, with cure rates of about 85%, but at a cost of increased toxicity. In a previous study, Dr. Gallamini and colleagues reported that fluorodeoxyglucose (FDG)-PET scan is more effective than the International Prognostic Score (IPS) at predicting treatment outcome in patients with advanced-stage HL who are treated with ABVD. In the current study, they evaluated whether FDG-PET could predict outcomes after 2 cycles of ABVD treatment. Patients treated with ABVD (N = 260) also received consolidation radiotherapy in case of bulky presentation or residual tumour mass. Conventional radiological staging and FDG-PET scan were performed at baseline and after 2 courses of ABVD. After a median follow-up of 3.15 years (range, 0.6-6.3 years), 203 patients had continued complete response (cCR), 2 patients had partial response (PR), 43 patients progressed during therapy, and 12 patients relapsed. After 2 cycles of treatment, 52 patients were FDG-PET positive and 208 patients were FDG-PET negative. Of the 52 FDG-PET-positive patients, 44 (84.6%) demonstrated treatment failure, including 36 cases of progressive disease and 8 relapses. The remaining 8 patients had responded to treatment (7 CRs, 1 PR). In the remaining 208 patients who were FDG-PET negative after 2 cycles of treatment, 198 patients (96.6%) were in complete CR, 1 patient was in PR, while 11 patients had failed treatment. The proportion of patients achieving failure-free survival at 5 years was significantly higher in the FDG-PET-negative patients compared with the FDG-PET-positive patients (96.0% vs 24.5%, P < .0001). FDG-PET proved to be highly accurate in predicting outcomes in these patients. The sensitivity of FDG-PET for predicting 2-year progression-free survival (PFS) was 77%, specificity was 96%, and overall accuracy of FDG-PET was 92%. Factors that remained significant for influencing failure-free survival during multivariate analysis were stage IV disease (hazard ratio [HR], 2.2) and FDG-PET (HR, 21.8). Notably, IPS score added no additional predictive value when FDG-PET was used. "On the basis of these results, new trials are ongoing worldwide with risk-adapted therapy tailored to individual patients," Dr. Gallamini said. "As many as 80% of patients may be spared the unacceptable toxicity of more aggressive chemotherapy regimens." He also noted that Hodgkin's is well suited to the use of FDG-PET, but early assessment of other lymphomas, such as diffuse large B-cell lymphoma, may also be possible. "The cost of a PET scan in Europe is about 1,000 Euros, but when this cost is weighed against treatment outcomes, the benefits of this approach seem noteworthy," he added. [Presentation title: Gallamini Early Interim FDG-PET in Advanced-Stage Hodgkin Lymphoma (HL). Long-Term Results of the Italian-Danish Cooperative Study. Abstract 469.] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.