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Integrating genetic subtypes with PET scan monitoring to predict outcome in diffuse large B-cell lymphoma
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Integrating genetic subtypes with PET scan monitoring to predict outcome in diffuse large B-cell lymphoma
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Journal Article
Integrating genetic subtypes with PET scan monitoring to predict outcome in diffuse large B-cell lymphoma
2025
Overview
Next Generation Sequencing-based subtyping and interim- and end of treatment positron emission tomography (i/eot-PET) monitoring have high potential for upfront and on-treatment risk assessment of diffuse large B-cell lymphoma patients. We performed Dana Farber Cancer Institute (DFCI) and LymphGen genetic subtyping for the HOVON84 (n = 208, EudraCT-2006-005174-42) and PETAL (
n
= 204, EudraCT-2006-001641-33) trials retrospectively combined with DFCI genetic data (
n
= 304). For all R-CHOP treated patients (n = 592), C5/MCD- and C2/A53-subtypes show significantly worse outcome independent of the international prognostic index. For all subtypes, adverse prognostic value of i/eot-PET-positive status is confirmed. Consistent with frequent primary refractory disease, only 67% C2 patients become eot-PET-negative versus 81-88% for other subtypes. Indicative of high relapse rates, outcome of C5 i/eot-PET-negative patients remains significantly worse in HOVON-84, which trend validates in the PETAL and SAKK38-07 trials (NCT00544219). These results show the added value of integrated genetic subtyping and PET monitoring for prognostic stratification and subtype-specific trial design.
The prognostic impact of genetic subtypes in diffuse large B-cell lymphoma not otherwise specified (DLBCL-NOS) remains unclear. Here, the authors use data from multiple clinical trials to identify DLBCL-NOS genetic subtypes that are associated with patient outcomes, showing their potential value for prognostic stratification, trial design, and PET response monitoring.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 45
/ 45/22
/ 45/23
/ 692/4017
/ Adult
/ Aged
/ Antineoplastic Combined Chemotherapy Protocols - therapeutic use
/ Cyclophosphamide - therapeutic use
/ Doxorubicin - therapeutic use
/ Female
/ High-Throughput Nucleotide Sequencing - methods
/ Humanities and Social Sciences
/ Humans
/ Lymphoma
/ Lymphoma, Large B-Cell, Diffuse - diagnostic imaging
/ Lymphoma, Large B-Cell, Diffuse - drug therapy
/ Lymphoma, Large B-Cell, Diffuse - genetics
/ Male
/ Patients
/ Positron emission tomography
/ Positron-Emission Tomography - methods
/ Prednisone - therapeutic use
/ Science
