Follicular Lymphoma: PET-CT Surpasses CT For Response Assessment

Judith Trotman MBChB, FRACP, FRCPA Associate Professor Concord Hospital University of Sydney, AustraliaMedicalResearch.com Interview with:
Judith Trotman MBChB, FRACP, FRCPA
Associate Professor Concord Hospital
University of Sydney, Australia


Medical Research: What are the main findings of the study?

Dr. Trotman: That PET-CT (applying the cut-off of ≥4 on the now internationally recommended 5 Point Scale) is a more powerful predictor of both Progression Free and Overall Survival than conventional CT in patients responding to first line immunochemotherapy for advanced follicular lymphoma.  It is also a much stronger predictor than the pre-treatment prognostic indices FLIPI and FLIP2. Patients who achieve PET-negative status have a median PFS over 6 years compared to only 17 months in those who remain PET-positive.

Medical Research: What was most surprising about the results?

Dr. Trotman: How poorly CT performed as an early predictor of remission duration, consigning the majority of patients with an unconfirmed complete and partial remission to great uncertainty.

Medical Research: What should clinicians and patients take away from your report?

Dr. Trotman: That PET-CT should replace CT as the gold standard imaging modality for response assessment after first line therapy for follicular lymphoma and can be incorporated into decision making about how often to follow-up patients in first remission.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Trotman: PET-CT can now be a platform for response adapted therapies, especially those aimed to improve on the poor prognosis of patients who remain PET positive.  For most of these patients Follicular lymphoma can no longer be termed indolent.

Citation:

Prognostic value of PET-CT after first-line therapy in patients with follicular lymphoma: a pooled analysis of central scan review in three multicentre studies
Dr Judith Trotman FRACP,Stefano Luminari MD,Sami Boussetta MS,Annibale Versari MD,Jehan Dupuis MD,Christelle Tychyj MD,Luigi Marcheselli MS,Alina Berriolo-Riedinger MD,Antonella Franceschetto MD,Anne Julian MD,Fabien Ricard MD,Luca Guerra MD,Prof Corinne Haioun MD,Irene Biasoli MD,Prof Hervé Tilly MD,Prof Massimo Federico MD,Prof Gilles Salles MD,Prof Michel Meignan MD
The Lancet Haematology – 18 September 2014
DOI: 10.1016/S2352-3026(14)70008-0

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