Interim PET after 4 cycles predicts outcome in histomolecularly confirmed primary mediastinal B-cell lymphoma

作者：Vincent Camus, Thierry Jo Molina, Fabienne Desmots, Paul Blanc‐Durand, Salim Kanoun, Amine Moslemi, Philippe Ruminy, Steven Le Gouill, Hervé Ghesquières, Lucie Obéric, Franck Morschhauser, H. Tilly, Vincent Ribrag, Roch Houot, Catherine Thiéblemont, Hervé Maisonneuve, Fabien Claves, Krimo Bouabdallah, Corinne Haïoun, Gandhi Damaj, Luc-Matthieu Fornecker, Robin Noël, Pierre Feugier, David Sibon, Guillaume Cartron, Christophe Bonnet, W Bernard, Françoise Kraeber‐Bodéré, Caroline Bodet‐Milin, Jean‐Philippe Jais, Josette Brière, Cédric Rossi, Mad-Hélénie Elsensohn, Loïc Chartier, Emmanuel Itti, Fabrice Jardin, Thierry Fest · 发表于：Blood Advances · 年份：2025 · DOI：10.1182/bloodadvances.2024015577 · 被引用次数：5 · 研究领域：Lymphoma Diagnosis and Treatment、CNS Lymphoma Diagnosis and Treatment、CAR-T cell therapy research

ABSTRACT: The GAINED study was a randomized phase 3 trial comparing obinutuzumab (G) with rituximab (R) plus ACVBP (doxorubicin, cyclophosphamide, and prednisone, combined with either vindesine or bleomycin) or CHOP14 (cyclophosphamide, doxorubicin, vincristine, and prednisone, administered on a 14-day schedule) induction, followed by positron emission tomography (PET)-guided consolidation. This post hoc analysis aimed to detail the outcomes of patients with primary mediastinal B-cell lymphoma (PMBL), verified through expert pathological review and the use of gene expression profiling (GEP) and next-generation sequencing. Of 620 centrally reviewed patients, 138 (22.3%) confirmed PMBL cases were analyzed. Baseline characteristics included a median age of 33.5 years, 63.8% female, 55.1% stage III to IV, 90.6% elevated lactate dehydrogenase, 87.6% Eastern Cooperative Oncology Group performance status score of 0 to 1, 62.3% extranodal involvement, 52.6% age-adjusted International Prognostic Index (aaIPI) of 2% to 3%, and 53.6% bulk (>10 cm). Induction regimens were R/G-CHOP14 (56.9%) and R/G-ACVBP (43.1%). Postinduction treatments, based on interim PET results, included: standard consolidation chemotherapy (59.8%) if change in maximum standardized uptake value (ΔSUVmax) of >66% after cycle 2 and >70% after cycle 4 (PET2-/4-), intensive treatment and autologous transplantation (26.8%) if PET2+/4-, and salvage therapy (13.4%) if PET4+ (ΔSUVmax of ≤70%). Among patients with GEP data...