The results from a study in relapsed/refractory (r/r) large B-cell lymphoma patients receiving Chimeric Antigen Receptor (CAR) T-cell therapy looking at Positron Emission Tomography /Magnetic Resonance (PET/MR) imaging to predict survival was published recently in Cancer Imaging. The study investigated the predictive value of several quantitative PET/MR imaging metrics of both tumours and non-malignant lymphoid tissue, such as the bone marrow and spleen, and examined their predictive value for Progression Free Survival (PFS) and Overall Survival (OS). This research was conducted as a collaborative effort between Uppsala University and Antaros Medical.
Large B-cell lymphoma is the most common type of non-Hodgkin lymphoma in adults. It is an aggressive, fast-growing lymphoma that arises in the lymph nodes and often also in the spleen, liver, and bone marrow. While most large B-cell lymphoma patients respond to first-line chemoimmunotherapy treatment, approximately 40% will develop relapsed or refractory disease. In recent years, CD19-targeted CAR T-cell therapy has emerged as a promising treatment option for relapsed/refractory large B-cell lymphoma, and some have since been approved by the FDA. However, the therapeutic efficacy of CAR T-cells is limited by several factors including, but not limited to, associated life-threatening toxicities, antigen escape (development of resistance through loss of target antigen expression), and poor tumour infiltration due to the immunosuppressive tumour microenvironment and physical tumour barriers. Furthermore, CAR T-cell therapy is a highly specialised and expensive process.
As such, there is a need for biomarkers that can predict durable treatment response, i.e., survival. Previous work has used PET/CT imaging to investigate various tumour metrics to predict response to CAR T-cell therapy. The biggest advantage of using whole body PET/MR imaging is that it provides both structural and functional information for tumours and lymphoid tissues with less exposure to ionising radiation. Through investigating several imaging metrics, this explorative study found that PET/MR imaging has promising applications for CAR T-cell therapy evaluation in large B-cell lymphoma patients and can potentially be used for therapy outcome prediction.
Title: Whole body FDG PET/MR for progression free and overall survival prediction in patients with relapsed/refractory large B-cell lymphomas undergoing CAR T-cell therapy
Authors: Sjögholm T, Korenyushkin A, Gammelgård G, Lövgren T, Loskog A, Essand M, Kullberg J, Enblad G, Ahlstöm H
Find the publication here.