Day 30 SUVmax predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy

Ajlan Al Zaki; Lei Feng; Grace Watson; Sairah A. Ahmed; Haleigh Mistry; Loretta J. Nastoupil; Misha Hawkins; Ranjit Nair; Swaminathan P. Iyer; Hun J. Lee; Raphael E. Steiner; Christopher R. Flowers; Elizabeth J. Shpall; Partow Kebriaei; Sattva S. Neelapu; Jason R. Westin; Paolo Strati

doi:10.1182/bloodadvances.2021006715

Day 30 SUV_max predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy

Ajlan Al Zaki, Lei Feng, Grace Watson, Sairah A. Ahmed, Haleigh Mistry, Loretta J. Nastoupil, Misha Hawkins, Ranjit Nair, Swaminathan P. Iyer, Hun J. Lee, Raphael E. Steiner, Christopher R. Flowers, Elizabeth J. Shpall, Partow Kebriaei, Sattva S. Neelapu, Jason R. Westin, Paolo Strati

Research output: Contribution to journal › Article › peer-review

23 Scopus citations

Abstract

About 70% of patients with large B-cell lymphoma (LBCL) who are treated with axicabtagene ciloleucel (axi-cel) and who achieve a partial response (PR) or stable disease (SD) on the day 30 (D30) positron emission tomography (PET)–computed tomography (CT) scan progress; however, the factors that are predictive of progression are unknown. This a retrospective study of patients with LBCL who were treated with axi-cel at MD Anderson Cancer Center between January of 2018 and February of 2021. Among 50 patients with D30 PR/SD, 13 (26%) converted to a complete response (CR). Among 95 patients with a D30 CR, 72 (76%) remained in CR. On univariate analysis, the only day 25 characteristic associated with conversion from D30 PR/SD to subsequent CR was a higher platelet count (P 5 .05). The only D30 factor associated with conversion from D30 PR/SD to subsequent CR was a lower maximum standardized uptake volume (SUV_max; P, .001); all patients with D30 SUV_max $ 10 progressed. After a median follow-up of 12 months, no significant difference in median progression-free survival was observed between patients who converted from D30 PR/SD to subsequent CR and those who had been in CR since D30 (P 5 .19). Novel predictive and prognostic markers based on tissue biopsy and noninvasive diagnostic assays are needed to more effectively identify these patients and characterize the biology of their residual disease.

Original language	English (US)
Pages (from-to)	2867-2871
Number of pages	5
Journal	Blood Advances
Volume	6
Issue number	9
DOIs	https://doi.org/10.1182/bloodadvances.2021006715
State	Published - May 10 2022

ASJC Scopus subject areas

Hematology

MD Anderson CCSG core facilities

Biostatistics Resource Group

Access to Document

10.1182/bloodadvances.2021006715

Cite this

Al Zaki, A., Feng, L., Watson, G., Ahmed, S. A., Mistry, H., Nastoupil, L. J., Hawkins, M., Nair, R., Iyer, S. P., Lee, H. J., Steiner, R. E., Flowers, C. R., Shpall, E. J., Kebriaei, P., Neelapu, S. S., Westin, J. R., & Strati, P. (2022). Day 30 SUV_max predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy. Blood Advances, 6(9), 2867-2871. https://doi.org/10.1182/bloodadvances.2021006715

Al Zaki, A , Feng, L, Watson, G, Ahmed, SA, Mistry, H, Nastoupil, LJ, Hawkins, M, Nair, R , Iyer, SP , Lee, HJ, Steiner, RE, Flowers, CR , Shpall, EJ , Kebriaei, P , Neelapu, SS , Westin, JR & Strati, P 2022, 'Day 30 SUV_max predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy', Blood Advances, vol. 6, no. 9, pp. 2867-2871. https://doi.org/10.1182/bloodadvances.2021006715

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title = "Day 30 SUVmax predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy",

abstract = "About 70% of patients with large B-cell lymphoma (LBCL) who are treated with axicabtagene ciloleucel (axi-cel) and who achieve a partial response (PR) or stable disease (SD) on the day 30 (D30) positron emission tomography (PET)–computed tomography (CT) scan progress; however, the factors that are predictive of progression are unknown. This a retrospective study of patients with LBCL who were treated with axi-cel at MD Anderson Cancer Center between January of 2018 and February of 2021. Among 50 patients with D30 PR/SD, 13 (26%) converted to a complete response (CR). Among 95 patients with a D30 CR, 72 (76%) remained in CR. On univariate analysis, the only day 25 characteristic associated with conversion from D30 PR/SD to subsequent CR was a higher platelet count (P 5 .05). The only D30 factor associated with conversion from D30 PR/SD to subsequent CR was a lower maximum standardized uptake volume (SUVmax; P, .001); all patients with D30 SUVmax $ 10 progressed. After a median follow-up of 12 months, no significant difference in median progression-free survival was observed between patients who converted from D30 PR/SD to subsequent CR and those who had been in CR since D30 (P 5 .19). Novel predictive and prognostic markers based on tissue biopsy and noninvasive diagnostic assays are needed to more effectively identify these patients and characterize the biology of their residual disease.",

author = "{Al Zaki}, Ajlan and Lei Feng and Grace Watson and Ahmed, {Sairah A.} and Haleigh Mistry and Nastoupil, {Loretta J.} and Misha Hawkins and Ranjit Nair and Iyer, {Swaminathan P.} and Lee, {Hun J.} and Steiner, {Raphael E.} and Flowers, {Christopher R.} and Shpall, {Elizabeth J.} and Partow Kebriaei and Neelapu, {Sattva S.} and Westin, {Jason R.} and Paolo Strati",

note = "Publisher Copyright: {\textcopyright} 2022 by The American Society of Hematology.",

year = "2022",

month = may,

day = "10",

doi = "10.1182/bloodadvances.2021006715",

language = "English (US)",

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T1 - Day 30 SUVmax predicts progression in patients with lymphoma achieving PR/SD after CAR T-cell therapy

AU - Al Zaki, Ajlan

AU - Feng, Lei

AU - Watson, Grace

AU - Ahmed, Sairah A.

AU - Mistry, Haleigh

AU - Nastoupil, Loretta J.

AU - Hawkins, Misha

AU - Nair, Ranjit

AU - Iyer, Swaminathan P.

AU - Lee, Hun J.

AU - Steiner, Raphael E.

AU - Flowers, Christopher R.

AU - Shpall, Elizabeth J.

AU - Kebriaei, Partow

AU - Neelapu, Sattva S.

AU - Westin, Jason R.

AU - Strati, Paolo

PY - 2022/5/10

Y1 - 2022/5/10

N2 - About 70% of patients with large B-cell lymphoma (LBCL) who are treated with axicabtagene ciloleucel (axi-cel) and who achieve a partial response (PR) or stable disease (SD) on the day 30 (D30) positron emission tomography (PET)–computed tomography (CT) scan progress; however, the factors that are predictive of progression are unknown. This a retrospective study of patients with LBCL who were treated with axi-cel at MD Anderson Cancer Center between January of 2018 and February of 2021. Among 50 patients with D30 PR/SD, 13 (26%) converted to a complete response (CR). Among 95 patients with a D30 CR, 72 (76%) remained in CR. On univariate analysis, the only day 25 characteristic associated with conversion from D30 PR/SD to subsequent CR was a higher platelet count (P 5 .05). The only D30 factor associated with conversion from D30 PR/SD to subsequent CR was a lower maximum standardized uptake volume (SUVmax; P, .001); all patients with D30 SUVmax $ 10 progressed. After a median follow-up of 12 months, no significant difference in median progression-free survival was observed between patients who converted from D30 PR/SD to subsequent CR and those who had been in CR since D30 (P 5 .19). Novel predictive and prognostic markers based on tissue biopsy and noninvasive diagnostic assays are needed to more effectively identify these patients and characterize the biology of their residual disease.

AB - About 70% of patients with large B-cell lymphoma (LBCL) who are treated with axicabtagene ciloleucel (axi-cel) and who achieve a partial response (PR) or stable disease (SD) on the day 30 (D30) positron emission tomography (PET)–computed tomography (CT) scan progress; however, the factors that are predictive of progression are unknown. This a retrospective study of patients with LBCL who were treated with axi-cel at MD Anderson Cancer Center between January of 2018 and February of 2021. Among 50 patients with D30 PR/SD, 13 (26%) converted to a complete response (CR). Among 95 patients with a D30 CR, 72 (76%) remained in CR. On univariate analysis, the only day 25 characteristic associated with conversion from D30 PR/SD to subsequent CR was a higher platelet count (P 5 .05). The only D30 factor associated with conversion from D30 PR/SD to subsequent CR was a lower maximum standardized uptake volume (SUVmax; P, .001); all patients with D30 SUVmax $ 10 progressed. After a median follow-up of 12 months, no significant difference in median progression-free survival was observed between patients who converted from D30 PR/SD to subsequent CR and those who had been in CR since D30 (P 5 .19). Novel predictive and prognostic markers based on tissue biopsy and noninvasive diagnostic assays are needed to more effectively identify these patients and characterize the biology of their residual disease.

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