Potential of MTV-based risk scores in relapsed and refractory large B-cell lymphoma: Data from a multicenter cohort undergoing chimeric antigen receptor T-cell therapy

Ziel/Aim: Chimeric antigen receptor (CAR) T-cell therapy has proven highly effective in relapsed and refractory large B-cell lymphomas. Yet, it remains an open question how to identify potential non-responders ahead of treatment and further improve their outcome. Several international research groups are currently working on the integration of metabolic tumor volume (MTV), measured by 2-[¹⁸F]fluoro-2-deoxy-D-glucose positron emission tomography (PET), into newly developed models. Therefore, we examined the predictive value of proposed risk scores in patients undergoing CAR T-cell therapy.

Methodik/Methods: Our analysis set included 94 patients from five German university hospitals and one Italian center who underwent PET imaging before CAR T-cell treatment. We evaluated the risk scores introduced by Leithner et al. [1], Thieblemont et al. [2], and our group [3], which, alongside MTV, included lactate dehydrogenase levels, Eastern Cooperative Oncology Group performance status, and extra-nodal involvement, respectively. The performance of MTV-based models in predicting six-month progression-free survival (PFS) was determined based on receiver operating characteristic analysis and compared with the established International Prognostic Index (IPI).

Ergebnisse/Results: The risk scores considered showed different predictive power regarding PFS in patients who underwent CAR T-cell therapy. We calculated areas under the curve (AUC) of 0.53 (95% confidence interval [CI], [0.42, 0.64]), 0.62 (95% CI, [0.51, 0.72]), and 0.69 (95% CI, [0.58, 0.79]) for the models published by Leithner et al., Thieblemont et al., and our group, respectively. Moreover, the IPI, currently used within clinical routine, achieved an AUC of 0.63 (95% CI, [0.53, 0.73]).

Schlussfolgerungen/Conclusions: Our data indicate that the MTV-based models proposed may be useful for risk assessment in large B-cell lymphoma patients undergoing CAR T-cell therapy. Additionally, we demonstrated their potential to outperform the established IPI, suggesting future research should focus on PET biomarkers. A larger number of patients is currently being enrolled for an ongoing validation study.

 

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• Literatur/References

• 1 Leithner D. et al. J Hematol Oncol 2024; 17: 21
• 2 Thieblemont C. et al. Blood Adv 2022; 6: 5995-6004
• 3 Voltin CA. et al. Eur J Nucl Med Mol Imaging 2024; 51: 1361-70

Publication History

Article published online:
12 March 2025