Beck, Michael and Blumenberg, Viktoria and Buecklein, Veit L. and Bundschuh, Ralph A. and Harrer, Dennis C. and Hirschbuehl, Klaus and Jung, Johannes and Kunz, Wolfgang G. and Menhart, Karin and Winkelmann, Michael and Yakushev, Igor and Illert, Anna Lena and Eckstein, Markus and Voelkl, Simon and Claus, Rainer and Hansmann, Leo and Hecker, Judith S. and Kuwert, Torsten and Mackensen, Andreas and Subklewe, Marion and Hellwig, Dirk and Mueller, Fabian (2025) Liver-FDG-uptake augments early PET/CT prognostic value for CD19-targeted CAR-T cell therapy in diffuse large B cell lymphoma. EJNMMI RESEARCH, 15 (1): 25. ISSN 2191-219X,
Full text not available from this repository. (Request a copy)Abstract
BackgroundDespite revolutionary efficacy of CD19-CAR-T cell therapy (CAR-T) in aggressive B cell lymphoma, many patients still relapse mostly early. In early failure, distinct drugs support CAR-T which makes reliable and early prediction of imminent relapse/refractoriness critical. A complete metabolic remission (CR) on Fluor-18-Deoxyglucose (FDG) Positron-Emission-Computed Tomography (PET) 30 days after CAR-T (PET30) strongly predicts progression-free survival (PFS), but still fails in a relevant proportion of patients. We aimed to identify additional routine parameters in PET evaluation to enhance CAR-T response prediction.ResultsThirty patients with aggressive B cell lymphoma treated with CAR-T were retrospectively analyzed. Pre-CAR-T, LDH was the strongest PFS-predictor also by multivariate analysis. Post-CAR-T, 10 out of 14 patients (71.4%) with PET30-CR remained in disease remission, while 12 out of 16 patients (75%) with incomplete metabolic remission (PET30-nCR) relapsed after CAR-T. 28.6% of patients with PET30-CR ultimately progressed. Change of liver FDG-uptake from baseline to day30 (Delta-Liver-SUVmean) was identified as an independent biomarker for response. PET30-nCR and a decrease of Delta-Liver-SUVmean were associated with a high risk of tumor progression (HR 4.79 and 3.99, respectively). The combination of PET30 and Delta-Liver-SUVmean identified patients at very low, at intermediate and at very high risk of relapse (PFS not reached, 7.5 months, 1.5 months, respectively).ConclusionAdditionally to PET30 metabolic remission, longitudinal metabolic changes in Delta-Liver-SUVmean predicted CAR-T efficiency. Our results may guide early intervention studies aiming to enhance CAR-T particularly in the very high-risk patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RECOMMENDATIONS; BLOOD; CAR T cell therapy; DLBCL; FDG PET; Liver-SUV |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Abteilung für Nuklearmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Apr 2026 10:02 |
| Last Modified: | 23 Apr 2026 10:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/67565 |
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