Frontiers in Oncology (Aug 2021)
Tumor Burden Measured by 18F-FDG PET/CT in Predicting Efficacy and Adverse Effects of Chimeric Antigen Receptor T-Cell Therapy in Non-Hodgkin Lymphoma
- Ruimin Hong,
- Ruimin Hong,
- Ruimin Hong,
- Ruimin Hong,
- Elaine Tan Su Yin,
- Elaine Tan Su Yin,
- Elaine Tan Su Yin,
- Elaine Tan Su Yin,
- Linqin Wang,
- Linqin Wang,
- Linqin Wang,
- Linqin Wang,
- Xin Zhao,
- Linghui Zhou,
- Linghui Zhou,
- Linghui Zhou,
- Linghui Zhou,
- Guangfa Wang,
- Mingming Zhang,
- Mingming Zhang,
- Mingming Zhang,
- Mingming Zhang,
- Houli Zhao,
- Houli Zhao,
- Houli Zhao,
- Houli Zhao,
- Guoqing Wei,
- Guoqing Wei,
- Guoqing Wei,
- Guoqing Wei,
- Yiyun Wang,
- Yiyun Wang,
- Yiyun Wang,
- Yiyun Wang,
- Wenjun Wu,
- Wenjun Wu,
- Wenjun Wu,
- Wenjun Wu,
- Yafei Zhang,
- Fang Ni,
- Fang Ni,
- Fang Ni,
- Fang Ni,
- Yongxian Hu,
- Yongxian Hu,
- Yongxian Hu,
- Yongxian Hu,
- He Huang,
- He Huang,
- He Huang,
- He Huang,
- Kui Zhao
Affiliations
- Ruimin Hong
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Ruimin Hong
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Ruimin Hong
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Ruimin Hong
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Elaine Tan Su Yin
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Elaine Tan Su Yin
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Elaine Tan Su Yin
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Elaine Tan Su Yin
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Linqin Wang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Linqin Wang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Linqin Wang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Linqin Wang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Xin Zhao
- Positron Emission Tomography (PET) Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Linghui Zhou
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Linghui Zhou
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Linghui Zhou
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Linghui Zhou
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Guangfa Wang
- Positron Emission Tomography (PET) Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Mingming Zhang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Mingming Zhang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Mingming Zhang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Mingming Zhang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Houli Zhao
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Houli Zhao
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Houli Zhao
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Houli Zhao
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Guoqing Wei
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Guoqing Wei
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Guoqing Wei
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Guoqing Wei
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yiyun Wang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Yiyun Wang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yiyun Wang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yiyun Wang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Wenjun Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Wenjun Wu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Wenjun Wu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Wenjun Wu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yafei Zhang
- Positron Emission Tomography (PET) Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Fang Ni
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Fang Ni
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Fang Ni
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Fang Ni
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Yongxian Hu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Yongxian Hu
- Institute of Hematology, Zhejiang University, Hangzhou, China
- Yongxian Hu
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- Yongxian Hu
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- He Huang
- Institute of Hematology, Zhejiang University, Hangzhou, China
- He Huang
- Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, China
- He Huang
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, China
- Kui Zhao
- Positron Emission Tomography (PET) Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- DOI
- https://doi.org/10.3389/fonc.2021.713577
- Journal volume & issue
-
Vol. 11
Abstract
Chimeric antigen receptor (CAR) T-cell therapy has exhibited promising clinical outcomes in treating relapsed/refractory (R/R) B-cell hematologic malignancies. Current studies have shown a close correlation between baseline tumor burden and therapeutic response in CAR-T cell therapy. However, the roles of PET/CT metabolic parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), remain unclear in this setting. In this study, we retrospectively reviewed 41 R/R NHL patients. 18F-FDG PET/CT was used to measure the average standardized uptake value (SUVavg), MTV, and TLG of the lymphomatous lesions. These patients were divided into two groups according to the optimal cutoff values of respective PET/CT metabolic parameters. The multivariate analysis depicted that early post-therapy SUVavg (HR: 1.418, 95% CI: 1.029, 1.955; p = 0.033) and MTV (HR: 1.001, 95% CI: 1.000, 1.002; p = 0.041) were independent risk factors associated with OS and PFS, respectively. Patients with baseline SUVavg < 4.36 achieved a superior 1-year OS rate than the SUVavg ≥ 4.36 group (100.0% vs. 44.9%, p = 0.019). For the patients with lower values in early post-therapy SUVavg (<2.60) (51.1% vs. 0%, p < 0.001), MTV (<0.55 cm3) (53.6% vs. 0.0%, p = 0.001), and TLG (<1.54) (53.6% vs. 0.0%, p = 0.001), their 1-year PFS rates were higher than the compared groups. Moreover, patients with higher baseline tumor burdens were found to have significantly increased CRS incidence and cytokine levels. In conclusion, the PET/CT metabolic parameters are closely related to OS, PFS, and CRS in R/R NHL patients treated with CAR-T cells. This study may pave the way for building a comprehensive assessment system of tumor burden using 18F-FDG PET/CT, which can optimize therapeutic and supportive approaches in CAR-T cell therapy.
Keywords
- chimeric antigen receptor T-cell therapy
- non-Hodgkin lymphoma
- metabolic tumor burden
- FDG PET/CT
- prognosis
- adverse effects