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Negative PET/CT After One Cycle of Chemotherapy Strongly Predicts Favorable Outcome in Hodgkin Lymphoma

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Key Points

  • Two-year progression-free survival was 94.1% in PET1-negative patients vs 40.8% in PET1-positive patients.
  • All PET1-negative patients were also PET2-negative.

Negative 18F–fluorodeoxyglucose positron-emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy (PET2) has been shown to be associated with favorable prognosis in Hodgkin lymphoma. In a prospective study reported in the Journal of Clinical Oncology, Hutchings et al found that negative findings after the first cycle of chemotherapy (PET1) is strongly predictive of superior outcome.  

Study Details

The study included 126 patients from the United States, Italy, Poland, and Denmark. All PET scans were read by two blinded independent reviewers in different countries using the Deauville 5-point scale. The main endpoint was 2-year progression-free survival.

All patients underwent PET1 and 89 underwent both PET1 and PET2. Overall, PET1 was positive in 37 patients and negative in 89 patients. Median follow-up was 29 months.  

Progression-Free Survival Outcomes

Two-year progression-free survival was 94.1% in PET1-negative patients vs 40.8% in PET1-positive patients (P < .001). All five patients who died during the observation period were PET1-negative (P < .001 for 2-year overall survival).

All PET1-negative patients were also PET2-negative. Among patients undergoing both PET1 and PET2, 2-year progression-free survival was 98.3% in PET1-negative patients vs 38.5% in PET1-positive patients and 90.2% in PET2-negative patients vs 23.1% in PET2-positive patients. Three-year progression-free survival was 98.3% in PET1-negative patients vs 0% in PET1-positive patients and 90.2% in PET2-negative patients vs 0% in PET2-positive patients.  

The investigators concluded, “PET after one cycle of chemotherapy is highly prognostic in [Hodgkin lymphoma]. No other prognostic tool identifies a group of patients … with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.”

Martin Hutchings, MD, PhD, of Rigshospitalet, Copenhagen, is the corresponding author for the Journal of Clinical Oncology article.

The study authors indicated no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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