Interim PET
Purpose
In lymphoma, [18]FDG-PET is well established for staging and end-of-therapy response assessment. A promising more recent application is ‘early response assessment’, meaning that response to treatment is predicted using interim PET (i-PET), i.e. PET during treatment. Timely assessment of forthcoming therapy failure in individual patients would have a profound impact on patient care by avoiding unnecessary toxicity and timely switching to potentially curative alternatives. Several observational studies have indicated that i-PET may be effective in early response prediction, but inconsistencies prevail, especially in non-Hodgkin’s lymphoma (NHL) including diffuse large B-cell lymphoma (DLBCL). It is unclear to which extent these are due to differences in the timing of PET during therapy, different PET positivity criteria, different therapies and/or different subtypes of lymphoma. There is an urgent need to address these issues but this requires an integral approach using the results of various studies.
Overall aim
To validate [18]FDG-PET as a biomarker of response in first-line BLBCL therapy using meta-analysis of individual patient data, and to determine its cost-effectiveness.
Objectives
To build a PETRA database consisting of individual patient data (including PET scans) of the major international clinical studies on the value of i-PET in lymphomas
To determine the optimal timing of i-PET during first-line therapy with R-CHOP of DLBCL
To determine which i-PET response criteria perform best in predicting end-of-therapy response rate and progression-free survival at 2 years follow-up in patients with DLBCL
To assess whether and how chemo-immunotherapy affects the performance of i-PET
To assess whether and how type of NHL affects the performance of interim [18]FDG-PET
To determine the cost-effectiveness of i-PET in DLBCL