18F-FDG PET/CT metrics-based stratification of large B-cell lymphoma receiving CAR-T cell therapy: immunosuppressive tumor microenvironment as a negative prognostic indicator in patients with high tumor burden

作者：Lingshuang Sheng, Rong Shen, Zi‐Xun Yan, Chao Wang, Xin Zheng, Yilun Zhang, Hao-Xu Yang, Wen Wu, Pengpeng Xu, Shu Cheng, Emmanuel Bachy, Pierre Sesques, Nicolas Jacquet-Francillon, Xufeng Jiang, Weili Zhao, Li Wang · 发表于：Biomarker Research · 年份：2024 · DOI：10.1186/s40364-024-00650-5 · 被引用次数：6 · 研究领域：CAR-T cell therapy research、Virus-based gene therapy research、Sarcoma Diagnosis and Treatment

Abstract Chimeric antigen receptor T (CAR-T) cell therapy has greatly improved the prognosis of relapsed and refractory patients with large B-cell lymphoma (LBCL). Early identification and intervention of patients who may respond poorly to CAR-T cell therapy will help to improve the efficacy. Ninety patients from a Chinese cohort who received CAR-T cell therapy and underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scans at the screening stage (median time to infusion 53.5 days, range 27–176 days), 1 month and 3 months after CAR-T cell infusion were analyzed, with RNA-sequencing conducted on 47 patients at the screening stage. Patients with maximum diameter of the largest lesion (Dmax) < 6 cm ( N = 60) at screening stage showed significantly higher 3-month complete response rate (85.0% vs. 33.3%, P < 0.001), progression-free survival (HR 0.17; 95% CI 0.08–0.35, P < 0.001) and overall survival (HR 0.18; 95% CI 0.08–0.40, P < 0.001) than those with Dmax ≥ 6 cm ( N = 30). Besides, at the screening stage, Dmax combined with extranodal involvement was more efficient in distinguishing patient outcomes. The best cut-off values for total metabolic tumor volume (tMTV) and total lesion glycolysis (tTLG) at the screening stage were 50cm 3 and 500 g, respectively. A prediction model combining maximum standardized uptake value (SUVmax) at 1 month after CAR-T cell therapy (M1) and tTLG clearance rate was established to predict ear...