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Pineau J, Lima LMP, Le Roy MM, Marionneau-Lambot S, Cordier M, Le Saëc P, Zeevaart JR, Driver CHS, Faivre-Chauvet A, Le Bris N, Tripier R. Highly inert Cu(II) complexes of C-aryl bifunctional cyclam-picolinates with remarkable 64Cu-labelling and biodistribution. Chem Commun (Camb) 2023; 59:888-891. [PMID: 36598060 DOI: 10.1039/d2cc06602e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cyclam-picolinate chelators were functionalized via click chemistry with an additional carboxyl group for subsequent bioconjugation to antibodies or for the modification of the overall charge of the corresponding 64Cu-radiocomplexes. The C-aryl functionalization strategy developed here preserves the chemical properties of the radiocomplexes whilst deeply enhancing their applications within nuclear medicine.
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Affiliation(s)
- Julie Pineau
- Univ Brest, CEMCA, UMR CNRS 6521, 6 Av. Victor le Gorgeu, Brest 29200, France.
| | - Luís M P Lima
- Nova University of Lisbon, ITQB, Av. da República, Oeiras 2780-157, Portugal
| | - Marie M Le Roy
- Univ Brest, CEMCA, UMR CNRS 6521, 6 Av. Victor le Gorgeu, Brest 29200, France.
| | | | - Marie Cordier
- Univ Rennes, ISCR, UMR CNRS 6226, 263 Av. Général Leclerc, Rennes 35000, France
| | - Patricia Le Saëc
- Univ Nantes, CRCI2NA, UMR INSERM 1307, UMR CNRS 6075, 8 Quai Moncousu, Nantes 44007, France
| | - Jan Rijn Zeevaart
- South African Nuclear Energy Corporation, Elias Motsoaledi Street, R104 Pelindaba, North West, 0240, South Africa
| | - Cathryn H S Driver
- South African Nuclear Energy Corporation, Elias Motsoaledi Street, R104 Pelindaba, North West, 0240, South Africa
| | - Alain Faivre-Chauvet
- Univ Nantes, CRCI2NA, UMR INSERM 1307, UMR CNRS 6075, 8 Quai Moncousu, Nantes 44007, France
| | - Nathalie Le Bris
- Univ Brest, CEMCA, UMR CNRS 6521, 6 Av. Victor le Gorgeu, Brest 29200, France.
| | - Raphaël Tripier
- Univ Brest, CEMCA, UMR CNRS 6521, 6 Av. Victor le Gorgeu, Brest 29200, France.
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Choi JH, Lim I, Byun BH, Kim BI, Choi CW, Kang HJ, Shin DY, Lim SM. The role of 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma after radioimmunotherapy using 131I-rituximab as consolidation therapy. PLoS One 2022; 17:e0273839. [PMID: 36156599 PMCID: PMC9512194 DOI: 10.1371/journal.pone.0273839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the prognostic value of pretreatment 18F-FDG PET/CT after consolidation therapy of 131I-rituximab in patients with diffuse large B-cell lymphoma (DLBCL) who had acquired complete remission after receiving chemotherapy. Methods Patients who were diagnosed with DLBCL via histologic confirmation were retrospectively reviewed. All patients had achieved complete remission after 6 to 8 cycles of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone) chemotherapy after which they underwent consolidation treatment with 131I-rituximab. 18F-FDG PET/CT scans were performed before R-CHOP for initial staging. The largest diameter of tumor, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained from pretreatment 18F-FDG PET/CT scans. Receiver-operating characteristic curves analysis was introduced for assessing the optimal criteria. Kaplan-Meier curve survival analysis was performed to evaluate both relapse free survival (RFS) and overall survival (OS). Results A total of 15 patients (12 males and 3 females) with a mean age of 56 (range, 30–73) years were enrolled. The median follow-up period of these patients was 73 months (range, 11–108 months). Four (27%) patients relapsed. Of them, three died during follow-up. Median values of the largest tumor size, highest SUVmax, MTV, and TLG were 5.3 cm (range, 2.0–16.4 cm), 20.2 (range, 11.1–67.4), 231.51 (range, 15–38.34), and 1277.95 (range, 238.37–10341.04), respectively. Patients with SUVmax less than or equal to 16.9 showed significantly worse RFS than patients with SUVmax greater than 16.9 (5-year RFS rate: 60% vs. 100%, p = 0.008). Patients with SUVmax less than or equal to 16.9 showed significantly worse OS than patients with SUVmax greater than 16.9 (5-year OS rate: 80% vs. 100% p = 0.042). Conclusion Higher SUVmax at pretreatment 18F-FDG PET/CT was associated with better relapse free survival and overall survival in DLBCL patients after consolidation therapy with 131I-rituximab. However, because this study has a small number of patients, a phase 3 study with a larger number of patients is needed for clinical application in the future.
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Affiliation(s)
- Joon Ho Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
- Department of Radiological & Medico-Oncological Sciences, University of Science and Technology (UST), Seoul, Korea
- * E-mail: (IL); (HJK)
| | - Byung Hyun Byun
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Chang Woon Choi
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
| | - Hye Jin Kang
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
- * E-mail: (IL); (HJK)
| | - Dong-Yeop Shin
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang Moo Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea
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Kitajima K, Okada M, Kashiwagi T, Yoshihara K, Tokugawa T, Sawada A, Yoshihara S, Fujimori Y, Yamakado K. Early evaluation of tumor response to 90Y-ibritumomab radioimmunotherapy in relapsed/refractory B cell non-Hodgkin lymphoma: what is the optimal timing for FDG-PET/CT? Eur Radiol 2019; 29:3935-3944. [PMID: 30899979 DOI: 10.1007/s00330-019-06134-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 02/14/2019] [Accepted: 03/06/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE To determine the earliest optimal timing for assessment of early response following radioimmunotherapy in non-Hodgkin lymphoma patients using FDG-PET/CT. METHODS FDG-PET/CT was performed prior to treatment (PET1), at 2 (PET2) weeks, and at 6 (PET3) weeks after 90Y-ibritumomab radioimmunotherapy in 55 patients. Response was evaluated based on the Deauville 5-point scale and Lugano criteria as well as semiquantitative analysis and compared with progression-free survival (PFS). RESULTS PET 2 showed complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD) in 33, 13, 6, and 3 patients, respectively, while PET 3 in 41, 8, 3, and 3 patients, respectively. Mean SUVmax of 168 target lesions decreased over time (PET1, 2, 3; 5.58 ± 2.58, 1.87 ± 1.78, 1.75 ± 2.25, respectively). Progression or recurrence after a median of 12.6 months (range 2.6-72.0 months) was seen in 44 patients. Patients with CMR or metabolic response (CMR + PMR) on PET2 showed significantly longer PFS as compared to those who did not (p = 0.00028 and p = 0.029, respectively). A similar significant difference was observed based on PET3 (p = 0.00013 and p = 0.017, respectively). The same trend was observed when analyzing only the subgroup of patients with follicular lymphoma (N = 43/55) (p < 0.0001). CONCLUSION Use of FDG-PET/CT findings with Lugano criteria for assessing early response to radioimmunotherapy after 6 weeks allowed for accurate evaluation and prognostic stratification, though scanning after 2 weeks was too soon to precisely evaluate response. KEY POINTS • The optimal timing of FDG-PET/CT to obtain a suitable tool for assessment of response after 90 Y-ibritumomab radioimmunotherapy of lymphoma has not yet been defined. • Assessment after 6 weeks by FDG-PET/CT using the Lugano criteria accurately evaluates treatment response and prognosis. • FDG-PET/CT performed 2 weeks after radioimmunotherapy is too early as it significantly misses objective responses.
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Affiliation(s)
- Kazuhiro Kitajima
- Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Masaya Okada
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Toru Kashiwagi
- Department of Healthcare office, Daimaru Matsuzaka Department Store, Osaka, 530-8202, Japan
| | - Kyoko Yoshihara
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Tazuko Tokugawa
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Akihiro Sawada
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Satoshi Yoshihara
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Yoshihiro Fujimori
- Division of Hematology, Department of Internal Medicine Department of Transfusion Medicine and Cellular Therapy, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
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England CG, Rui L, Cai W. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies. Eur J Nucl Med Mol Imaging 2016; 44:517-532. [PMID: 27844106 DOI: 10.1007/s00259-016-3560-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
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Eskian M, Khorasanizadeh M, Kraeber-Bodere F, Rezaei N. Radioimmunotherapy in non-Hodgkin lymphoma: Prediction and assessment of response. Crit Rev Oncol Hematol 2016; 107:182-189. [DOI: 10.1016/j.critrevonc.2016.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/24/2016] [Accepted: 10/12/2016] [Indexed: 12/20/2022] Open
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Guignard R, Zwarthoed C, Borra A, Darcourt J, Gallamini A. PET scan integration in lymphoma management. Int J Hematol Oncol 2013. [DOI: 10.2217/ijh.13.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Despite a marked improvement in lymphoma treatment outcome, current prognostic models, relying on a pretreatment set of static clinical variables, appear unable to support a risk-adapted therapeutic strategy. On the other hand, functional imaging with 18F-fluoro-2-deoxy-D-glucose (FDG)-PET proved to be a reliable tool to dynamically assess tumor FDG uptake changes during and after treatment. In this article we aim to review the prognostic value of FDG-PET in all the stages of Hodgkin’s and non-Hodgkin’s lymphoma management, without the intent to address the diagnostic value of PET or to replace available consensus guidelines. In particular we focused on two critical issues: the cost–effectiveness of PET in the overall strategy of lymphoma diagnosis and treatment; and ongoing clinical trials adopting an interim PET-based strategy to modulate treatment intensity based on PET results. Finally, new trends in multimodality imaging, as well as in new radiopharmaceutical tracers, are briefly reviewed.
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Affiliation(s)
- Renaud Guignard
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France.
| | - Colette Zwarthoed
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
| | - Anna Borra
- Hematology Department, Centre Antoine Lacassagne, Nice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
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7
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Lim I, Park JY, Kang HJ, Hwang JP, Lee SS, Kim KM, Choi TH, Yang SH, Kim BI, Choi CW, Lim SM. Prognostic significance of pretreatment ¹⁸F-FDG PET/CT in patients with relapsed/refractory B-cell non-Hodgkin's lymphoma treated by radioimmunotherapy using ¹³¹I-rituximab. Acta Haematol 2013; 130:74-82. [PMID: 23548464 DOI: 10.1159/000346436] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 11/22/2012] [Indexed: 01/04/2023]
Abstract
AIMS It was the aim of this paper to identify prognostic factors in patients with relapsed or refractory B-cell non-Hodgkin's lymphomas, treated by radioimmunotherapy (RIT) with radioiodinated human/murine chimeric anti-CD20 monoclonal antibody rituximab (¹³¹I-rituximab). METHODS Twenty-four patients were enrolled prospectively and were treated with unlabeled rituximab 70 mg and a therapeutic activity (median 7.3 GBq) of ¹³¹I-rituximab. Contrast-enhanced ¹⁸F-FDG PET/CT scans were performed before and after 1 month of RIT. Tumor sizes and maximum standardized uptake values (SUVmax) of scans were measured. RESULTS Four of the 24 patients survived. High SUVmax in a pretreatment scan was found to be related to poorer overall survival (OS) and progression-free survival (p = 0.04 and 0.02, respectively). Furthermore, a large tumor size in a pretreatment scan was associated with poorer OS but not with progression-free survival (p < 0.01 and p = 0.07, respectively). By multivariate analyses, a high SUVmax, a large tumor size in a pretreatment scan and diffuse large B-cell lymphoma histology were significantly associated with poorer OS [p = 0.04/hazard ratio (HR) = 3.54, p < 0.01/HR = 5.52, and p = 0.02/HR = 3.38, respectively). CONCLUSION SUVmax and tumor size determined by a pretreatment ¹⁸F-FDG PET/CT result as significant predictors of OS in patients with relapsed or refractory B-cell non-Hodgkin's lymphoma treated by RIT.
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Affiliation(s)
- Ilhan Lim
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea
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Dupas B, Augeul-Meunier K, Frampas E, Bodet-Milin C, Gastinne T, Le Gouill S. Staging and monitoring in the treatment of lymphomas. Diagn Interv Imaging 2013; 94:145-57. [PMID: 23332618 DOI: 10.1016/j.diii.2012.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lymphoma staging systematically includes a CT scan of the cervical, thoracic and abdominopelvic regions. PET is indicated in diffuse large B cell lymphomas (DLBCL) and Hodgkin's disease. Evaluation of the response to treatment is based on Cheson's 1999 morphological criteria, which have been replaced by the 2007 IWC criteria, which combine morphological and metabolic responses. CT and FDG-PET are complementary in characterizing residual masses: if negative, a PET scan indicates the absence of residual disease, if positive; it directs a CT-guided biopsy to obtain the histological evidence. Monitoring clinical features and laboratory values is primordial following treatment. Imaging is performed as a second intention for investigating a relapse, if necessary associated with a PET scan. Multimodal imaging implies multidisciplinary consultation between haematologists, imaging specialists and histopathologists.
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Affiliation(s)
- B Dupas
- Radiology and Medical Imaging Department, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
| | - K Augeul-Meunier
- Clinical Haematology Department, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - E Frampas
- Radiology and Medical Imaging Department, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - C Bodet-Milin
- Service de médecine nucléaire, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - T Gastinne
- Clinical Haematology Department, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - S Le Gouill
- Clinical Haematology Department, Hôtel-Dieu, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
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Bodet-Milin C, Eugène T, Gastinne T, Bailly C, Le Gouill S, Dupas B, Kraeber-Bodéré F. The role of FDG-PET scanning in assessing lymphoma in 2012. Diagn Interv Imaging 2013; 94:158-68. [PMID: 23295044 DOI: 10.1016/j.diii.2012.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Positron emission tomography (PET) has a proven role in the assessment diffuse large B-cell lymphoma (DLBCL) and Hodgkin's lymphoma (HL). The clinical impact of PET carried out at the end of the patient's course of treatment is undeniable and recommendations must be followed in the interpretation of these examinations. PET is highly recommended as part of the initial investigations of these diseases because it can be used as a reference for the interpretation at treatment completion and allows disease spread to be assessed with greater sensitivity and specificity than when computed tomography (CT) is used. It seems to be certain that PET is useful for interim examinations too, in terms of assessing prognosis in DLBCL and HL, although its impact in terms of early changes to treatment is still to be determined. The criteria for interpreting the results of these early assessments are still evolving and the annual meetings in Menton, France, of groups of experts are leading towards a uniform interpretation method. In other types of lymphoma, PET can be useful for confirming local disease staging, especially in follicular lymphoma, and for guiding biopsy in patients with low-grade lymphoma that is suspicious for transformation into more aggressive disease. Several studies are in agreement that PET is valuable for assessing prognosis at treatment completion in FL and mantle cell lymphoma, but prospective studies are needed for this new indication to be validated.
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Fluorodeoxyglucose F18
- France
- Hodgkin Disease/diagnosis
- Hodgkin Disease/pathology
- Humans
- Immunotherapy/methods
- Lymphoma/diagnostic imaging
- Lymphoma/pathology
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, Follicular/diagnosis
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Non-Hodgkin/diagnosis
- Lymphoma, Non-Hodgkin/pathology
- Positron-Emission Tomography
- Prognosis
- Sensitivity and Specificity
- Survival Analysis
- Tomography, X-Ray Computed
- Treatment Outcome
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Affiliation(s)
- C Bodet-Milin
- Nuclear medicine department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; CRCNA (Nantes/Angers cancer research centre), Inserm UMR 892, 9 quai Moncousu, 44093 Nantes cedex 1, France.
| | - T Eugène
- Nuclear medicine department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - T Gastinne
- Haematology department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - C Bailly
- Nuclear medicine department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - S Le Gouill
- Haematology department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; CRCNA (Nantes/Angers cancer research centre), Inserm UMR 892, 9 quai Moncousu, 44093 Nantes cedex 1, France
| | - B Dupas
- Radiology department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - F Kraeber-Bodéré
- Nuclear medicine department, Hôtel-Dieu, Nantes University Hospital, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Nuclear medicine department, René-Gauducheau Centre, boulevard Jacques-Monod, 44805 Nantes St-Herblain cedex, France; CRCNA (Nantes/Angers cancer research centre), Inserm UMR 892, 9 quai Moncousu, 44093 Nantes cedex 1, France
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10
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FDG-PET in Follicular Lymphoma Management. JOURNAL OF ONCOLOGY 2012; 2012:370272. [PMID: 22899920 PMCID: PMC3413977 DOI: 10.1155/2012/370272] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 06/26/2012] [Indexed: 11/23/2022]
Abstract
18-Fluoro-deoxyglucose positron emission tomography/computerised tomography (FDG PET/CT) is commonly used in the management of patients with lymphomas and is recommended for both initial staging and response assessment after treatment in patients with diffuse large B-cell lymphoma and Hodgkin lymphoma. Despite the FDG avidity of follicular lymphoma (FL), FDG PET/CT is not yet applied in standard clinical practice for patients with FL. However, FDG PET/CT is more accurate than conventional imaging for initial staging, often prompting significant management change, and allows noninvasive characterization to guide assessment of high-grade transformation. For restaging, FDG PET/CT assists in distinguishing between scar tissue and viable tumors in residual masses and a positive PET after induction treatment would seem to predict a shorter progression-free survival.
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11
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Ahmed S, Winter JN, Gordon LI, Evens AM. Radioimmunotherapy for the treatment of non-Hodgkin lymphoma: current status and future applications. Leuk Lymphoma 2010; 51:1163-77. [PMID: 20470217 DOI: 10.3109/10428191003793366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Radioimmunotherapy (RIT) has proved to be a safe and effective treatment for patients with relapsed or refractory indolent non-Hodgkin lymphoma (NHL) including rituximab-refractory follicular lymphoma. Further, FDA approval was recently granted for use in newly diagnosed follicular lymphoma as consolidative therapy immediately following induction chemotherapy. We detail herein the scope of clinical studies performed in relapsed/refractory and newly diagnosed indolent lymphoma and summarize the associated safety data. In addition, we discuss new applications of RIT that have been investigated in a variety of clinical scenarios (e.g. single-agent and sequential therapy in aggressive NHLs and as a component of stem cell transplant conditioning). The wide array of RIT-based studies have yielded encouraging data, although randomized controlled trials will be needed to prove superiority over conventional therapy. Novel therapeutic RIT-based strategies that continue to be explored include radiation-enhancing agents combined with RIT, pre-targeting, RIT fractionation, as well as the integration of new humanized antibodies. The field of RIT continues to evolve scientifically and grow clinically. A reappraisal of prior data and examination of recently published and ongoing studies will be important in recognizing the potential benefit of RIT in the treatment of NHL.
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Affiliation(s)
- Sairah Ahmed
- Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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12
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Morschhauser F, Kraeber-Bodéré F, Wegener WA, Harousseau JL, Petillon MO, Huglo D, Trümper LH, Meller J, Pfreundschuh M, Kirsch CM, Naumann R, Kropp J, Horne H, Teoh N, Le Gouill S, Bodet-Milin C, Chatal JF, Goldenberg DM. High rates of durable responses with anti-CD22 fractionated radioimmunotherapy: results of a multicenter, phase I/II study in non-Hodgkin's lymphoma. J Clin Oncol 2010; 28:3709-16. [PMID: 20625137 DOI: 10.1200/jco.2009.27.7863] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Fractionated radioimmunotherapy targeting CD22 may substantially improve responses and outcome in non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS A multicenter trial evaluated two or three weekly infusions of yttrium-90 ((90)Y) epratuzumab tetraxetan (humanized anti-CD22 antibody) in 64 patients with relapsed/refractory NHL, including 17 patients who underwent prior autologous stem-cell transplantation (ASCT). Objective (OR) and complete responses (CR/complete response unconfirmed [CRu]), as well as progression-free survival (PFS), were determined. RESULTS At the maximum total (90)Y dose of 45 mCi/m(2) (1,665 MBq/m(2)), grade 3 to 4 hematologic toxicities were reversible to grade 1 in patients with less than 25% bone marrow involvement. The overall OR rate and median PFS for all 61 evaluable patients was 62% (CR/CRu, 48%) and 9.5 months, respectively. Patients without prior ASCT obtained high OR rates of 71% (CR/CRu, 55%) across all NHL subtypes and (90)Y doses, even in poor-risk categories (refractory to last anti-CD20-containing regimen, 73% [CR/CRu, 60%]; bulky disease: 71% [CR/CRu, 43%]). Patients with prior ASCT received lower doses, but achieved an OR rate of 41% (CR/CRu, 29%). For patients with follicular lymphoma (FL), OR rates and median PFS increased with total (90)Y-dose, reaching 100% (CR/CRu, 92%) and 24.6 months, respectively, at the highest dose levels (> 30 mCi/m(2) total (90)Y-dose [1,110 MBq/m(2)]). Further, patients with FL refractory to prior anti-CD20-containing regimens achieved 90% (nine of 10 patients) OR and CR/CRu rates and a median PFS of 21.5 months. CONCLUSION Fractionated anti-CD22 radioimmunotherapy provides high total doses of (90)Y, yielding high rates of durable CR/CRus in relapsed/refractory NHL, resulting in 20 mCi/m(2) x 2 weeks as the recommended dose for future studies.
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Affiliation(s)
- Franck Morschhauser
- Service des Maladies du Sang, Centre Hospitalier Regional, L'Universitaire de Lille, France
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Storto G, De Renzo A, Pellegrino T, Perna F, De Falco T, Erra P, Nardelli A, Speranza A, Klain M, Rotoli B, Pace L. Assessment of metabolic response to radioimmunotherapy with 90Y-ibritumomab tiuxetan in patients with relapsed or refractory B-cell non-Hodgkin lymphoma. Radiology 2010; 254:245-52. [PMID: 20032155 DOI: 10.1148/radiol.09090603] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To prospectively compare the assessment of metabolic response to yttrium 90 ((90)Y)-ibritumomab tiuxetan radioimmunotherapy (RIT) by using fluorine 18 ((18)F) fluorodeoxyglucose (FDG) combined positron emission tomographic-computed tomographic (PET/CT) imaging at 2 and 6 months to determine the most appropriate time to detect therapeutic response in refractory non-Hodgkin lymphoma (NHL) patients treated with RIT. MATERIALS AND METHODS The ethical committee of the university approved the protocol and all patients signed informed consent. Twenty-three consecutive patients (10 women, 13 men; mean age, 51.8 years +/-7.3 [standard deviation]) treated by using RIT for relapsed or refractory follicular NHL were enrolled. For all patients, (18)F FDG PET/CT scanning was performed at baseline and at 2 and 6 months after RIT. Response was assessed by using the International Workshop Criteria (IWC) and revised criteria (IWC + PET) as well as the criteria of the European Organization for Research and Treatment of Cancer. One-way analysis of variance for repeated measures, receiver operator curve analysis, and Kaplan-Meier curves were used for statistical analysis. RESULTS PET/CT performed at 2 months revealed complete (n = 12) or partial (n = 4) metabolic response in 16 of 23 patients with complete or partial clinical response. These findings were all confirmed at 6-month scanning. PET/CT indicated refractory or persistent disease at 2 and 6 months in the remaining seven patients. Better overall survival was observed for patients with a reduction in the maximum standard uptake value of 49% or higher (both at 2 and 6 months after RIT) when compared with those with a decrease of less than 49% (P < .05). CONCLUSION Early assessment of response to RIT by using PET/CT might be useful in the identification of patients needing additional therapeutic strategies.
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Affiliation(s)
- Giovanni Storto
- Istituto di Ricerca e Cura a Carattere Scientifico, Università Federico II, Via Pansini 5, 80131 Naples, Italy.
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Barbet J, Chatal JF, Kraeber-Bodéré F. Les anticorps radiomarqués pour le traitement des cancers. Med Sci (Paris) 2009; 25:1039-45. [DOI: 10.1051/medsci/200925121039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cazaentre T, Morschhauser F, Vermandel M, Betrouni N, Prangère T, Steinling M, Huglo D. Pre-therapy 18F-FDG PET quantitative parameters help in predicting the response to radioimmunotherapy in non-Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2009; 37:494-504. [PMID: 19820933 DOI: 10.1007/s00259-009-1275-x] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 08/24/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE Radioimmunotherapy (RIT) is a new treatment option for patients with non-Hodgkin lymphoma (NHL). Response to RIT currently remains difficult to predict using conventional prognostic factors and could be refined using functional imaging. The goal of this work is to evaluate the value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting response to Yttrium 90-labeled monoclonal antibodies for patients with NHL. METHODS Thirty-five patients with NHL who had undergone (18)F-FDG PET prior to RIT with either (90)Y-ibritumomab tiuxetan (group A; n = 17) or (90)Y-epratuzumab tetraxetan (group B; n = 18) were included in this retrospective study. Four functional criteria were determined for each tumour lesion in a given patient: maximum and mean standard uptake values (SUVmax and SUVmean), functional lesion volume (LVol) and total lesion glycolysis (TLG, product of the volume and the SUVmean). For each patient, we determined highest SUVmax and SUVmean, cumulative TLG (TLGcum) and sum of all LVol (TVol) and compared their predictive value on response (complete or partial response according to IWC) to RIT with those of conventional prognostic factors in group A and B. RESULTS A total of 154 lesions were analysed. Nineteen patients (54%) responded to RIT according to IWC. In group A, response rate was 54, 75 and 75% in patients with a SUV max <20 g/ml, a TVol <100 ml and a TLGcum <1060 g, respectively while no patient above these thresholds responded (p < 0.005). In group B, the response rate was 93% for with SUVmax <15 g/ml while no patient above this threshold responded. With TLGcum below 1,360 g, 100% of the patient responded, compared with 37% of patients whose TLGcum was above this threshold (p < 0.05). By contrast, conventional prognostic factors failed to predict response. CONCLUSIONS Our preliminary results indicate that pre-therapy (18)F-FDG PET functional parameters such as SUVmax and TLG may help predicting more accurately response to single agent Y90 based RIT.
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Affiliation(s)
- Thomas Cazaentre
- Service de Médecine Nucléaire et Imagerie Fonctionnelle, CHU Lille, 59000, Lille, France.
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Abstract
PET has become a cornerstone procedure in modern lymphoma management. This paper reviews, from a clinical point of view, the evidence for using PET in the different subtypes of lymphoma and the different steps of their management. The reader is given an overview of the current PET-based interventional lymphoma trials and an insight into possible future developments in the field, including new PET tracers.
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Affiliation(s)
- Martin Hutchings
- Departments of Oncology and Haematology, Rigshospitalet, The Finsen Centre-Copenhagen University Hospital, 9 Blegdamsvej, Copenhagen Ø, Denmark.
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Jacene HA, Filice R, Kasecamp W, Wahl RL. 18F-FDG PET/CT for monitoring the response of lymphoma to radioimmunotherapy. J Nucl Med 2008; 50:8-17. [PMID: 19091903 DOI: 10.2967/jnumed.108.055376] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED We retrospectively evaluated 18F-FDG PET/CT for monitoring the response of non-Hodgkin's lymphoma to radioimmunotherapy. METHODS A total of 33 clinical patients received 131I-tositumomab (n=23) or 90Y-ibritumomab tiuxetan (n=10) and underwent 18F-FDG PET/CT scans before radioimmunotherapy and at 12 wk after radioimmunotherapy. A third scan was performed on 13 patients at 24 wk after radioimmunotherapy, 12 of whom did not receive interval therapy. Tumor metabolic activity was assessed before and after radioimmunotherapy visually and quantitatively by lean maximum standardized uptake value (SUVlean max). Response was assessed by the International Workshop Criteria (IWC) and Revised IWC, which includes 18F-FDG PET (IWC-PET). RESULTS Mean SUVlean max decreased from baseline in 244 target lesions 12 wk after radioimmunotherapy (from 6.51+/-4.05 to 3.94+/-4.41; P<0.01), regardless of response at 12 wk after radioimmunotherapy (P<or=0.02). After radioimmunotherapy, SUVlean max was lower for responders than for nonresponders (P<or=0.01). Median percentage change in SUVlean max of target lesions per patient was -51% (-95% to 97%). No significant difference in decline in SUVlean max between patients who received 131I-tositumomab and those who received 90Y-ibritumomab tiuxetan was demonstrated (-31%+/-51% vs. -47%+/-46%; P=0.38). Patients with greater than a 52% decline in SUVlean max tended toward longer survival (P=0.09) than those with lesser declines. The 12-wk overall response rate to radioimmunotherapy based on IWC was 42% (14/33); complete response rate was 15% (5/33). Eleven of 12 patients with progression at 12 wk had new disease sites, and in 4 patients, new disease sites were the only sites of progression. Of 108 lesions evaluated at 12 and 24 wk after radioimmunotherapy, 49 resolved at 12 wk and remained resolved at 24 wk, 17 gradually declined in SUV over 24 wk, and 37 initially decreased at 12 wk but increased at 24 wk. PET showed disease progression at 24 wk in 10 of 13 patients; 7 patients had new lesions and 1 was reclassified from partial response to complete response. CONCLUSION In non-Hodgkin's lymphoma, 18F-FDG uptake in tumors typically drops significantly after radioimmunotherapy. A continued decline in tumor SUVlean max between 12 and 24 wk without additional therapy can occur, suggesting a need for delayed-response assessment. In patients who progress after radioimmunotherapy, new sites of disease commonly develop, rather than recurrence or progression at previous disease sites. Large declines in 18F-FDG uptake tend to be seen in those with the longest progression-free survival.
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Affiliation(s)
- Heather A Jacene
- Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, USA
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Abstract
This article discusses evaluating response after and during therapy in various settings and for the types of cancers for which ample evidence demonstrates that PET imaging with flourodeoxyglucose provides a valuable surrogate for response to therapy. It also briefly discusses pitfalls in obtaining an optimal assessment of response and issues that need further attention for this modality to become established as an independent predictor of response to anticancer therapy.
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Affiliation(s)
- Lale Kostakoglu
- Division of Nuclear Medicine, Department of Radiology, Mount Sinai Medical Center, One Gustave Levy Place, Box: 1141, New York, NY 10029, USA.
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