title: In vivo treatment sensitivity testing with positron emission tomography/computed tomography after one cycle of chemotherapy for Hodgkin lymphoma.
abstract: OBJECTIVE
  Negative [(18)F]fluorodeoxyglucose (FDG) -positron emission tomography (PET)/computed tomography (CT) after two cycles of chemotherapy indicates a favorable prognosis in Hodgkin lymphoma (HL). We hypothesized that the negative predictive value would be even higher in patients responding rapidly enough to be PET negative after one cycle. This prospective study aimed to assess the prognostic value of PET after one cycle of chemotherapy in HL and to assess the dynamics of FDG uptake after one cycle (PET1) and after two cycles (PET2).
  
  
  METHODS
  All PET scans were read by two blinded, independent reviewers in different countries, according to the Deauville five-point scale. The main end point was progression-free survival (PFS) after 2 years.
  
  
  RESULTS
  A total of 126 patients were included, and all had PET1; 89 patients had both PET1 and PET2. The prognostic value of PET1 was statistically significant with respect to both PFS and overall survival. Two-year PFS for PET1-negative and PET1-positive patients was 94.1% and 40.8%, respectively. Among those with both PET1 and PET2, 2-year PFS was 98.3% and 38.5% for PET1-negative and PET1-positive patients and 90.2% and 23.1% for PET2-negative and PET2-positive patients, respectively. No PET1-negative patient was PET2 positive.
  
  
  CONCLUSIONS
  PET after one cycle of chemotherapy is highly prognostic in HL. No other prognostic tool identifies a group of patients with HL with a more favorable outcome than those patients with a negative PET1. In the absence of precise pretherapeutic predictive markers, PET1 is the best method for response-adapted strategies designed to select patients for less intensive treatment.
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC. martin.hutchings@gmail.com.
authors: Martin
authors: M
authors: Hutchings
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Lale
authors: L
authors: Kostakoglu
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Jan Maciej
authors: JM
authors: Zaucha
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Bogdan
authors: B
authors: Malkowski
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Alberto
authors: A
authors: Biggi
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Iwona
authors: I
authors: Danielewicz
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Annika
authors: A
authors: Loft
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Lena
authors: L
authors: Specht
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Dominick
authors: D
authors: Lamonica
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Myron S
authors: MS
authors: Czuczman
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Christina
authors: C
authors: Nanni
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Pier Luigi
authors: PL
authors: Zinzani
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Louis
authors: L
authors: Diehl
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Richard
authors: R
authors: Stern
authors: Martin Hutchings, Annika Loft, and Lena Specht, Rigshospitalet, Copenhagen, Denmark; Lale Kostakoglu and Richard Stern, Mount Sinai Medical Center; Morton Coleman, Weill Cornell Medical College/New York Presbyterian Hospital, New York; Dominick Lamonica and Myron S. Czuczman, Roswell Park Cancer Institute, Buffalo, NY; Jan Maciej Zaucha and Iwona Danielewicz, Medical University of Gdansk, Gdansk; Bogdan Malkowski, Centre of Oncology, Bydgoszcz, Poland; Alberto Biggi, Azienda Ospedaliera S. Croce e Carle, Cuneo; Christina Nanni and Pier Luigi Zinzani, University Hospital S. Orsola-Malpighi, Bologna, Italy; Louis Diehl, Duke University Medical Center, Durham, NC.
authors: Morton
authors: M
authors: Coleman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014747:Vinblastine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin