title: Molecular Profile and FDG-PET/CT Total Metabolic Tumor Volume Improve Risk Classification at Diagnosis for Patients with Diffuse Large B-Cell Lymphoma.
abstract: The prognostic impact of total metabolic tumor volume (TMTV) measured on pretreatment (18)F-FDG PET/CT and its added value to molecular characteristics was investigated in patients with diffuse large B-cell lymphoma (DLBCL).
  
  
  
  For 81 newly diagnosed patients with DLBCL treated with rituximab and CHOP/CHOP-like regimen, TMTV was computed using the 41% SUVmax thresholding method. According to the gene expression profile, determined using DASL (cDNA-mediated Annealing, Selection, Ligation and extension) technology, a subset of 57 patients was classified in germinal center B (GCB) or activated B-cell (ABC) subtypes and MYC or BCL2 overexpressed.
  
  
  
  Median follow-up was 64 months. Five-year progression-free survival (PFS) and overall survival (OS) were 60% and 63% in the whole population. Median pretherapy TMTV was 320 cm(3) (25th-75th percentiles 106-668 cm(3)). With a 300 cm(3) cutoff, patients with high TMTV (n = 43) had a 5-year PFS and OS of 43% and 46% compared with 76% and 78% for patients with a low TMTV (P = 0.0023, P = 0.0047). ABC status, MYC, or BCL2 overexpression and both overexpression ("dual expressor," DE) were significantly associated with a worse PFS and OS. TMTV combined with molecular data allowed a significant better risk substratification of ABC/GCB patients, on PFS and OS. High TMTV individualized in molecular-low-risk patients a group with a poor outcome (MYC, PFS=51%, OS=55% BCL2, PFS=49%, OS=49% or DE PFS=50%, OS=50%) and a group with a good outcome (MYC, PFS=93%, OS=93% BCL2, PFS=86%, OS=86%, or DE PFS=81%, OS=81%).
  
  
  
  The combination of molecular and imaging characteristics at diagnosis could lead to a more accurate selection of patients, to increase tailor therapy. Clin Cancer Res; 22(15); 3801-9. ©2016 AACR.
authors.affiliation: Nuclear Medicine Department, Henri Becquerel Cancer Center and Rouen University Hospital, Rouen, France. QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France. annesegolene.cottereau@aphp.fr.
authors.forename: Anne-Ségolène
authors.initials: AS
authors.lastname: Cottereau
authors.affiliation: Hematology Department, Centre Henri Becquerel, Rouen, France. UMR INSERM U918, Centre Henri Becquerel, Rouen, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Lanic
authors.affiliation: UMR INSERM U918, Centre Henri Becquerel, Rouen, France. Bioinformatics, University of Rouen, Mont Saint-Aignan, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Mareschal
authors.affiliation: Nuclear Medicine Department, Hôpital Henri Mondor, Créteil, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
authors.affiliation: Nuclear Medicine Department, Henri Becquerel Cancer Center and Rouen University Hospital, Rouen, France. QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vera
authors.affiliation: Hematology Department, Centre Henri Becquerel, Rouen, France. UMR INSERM U918, Centre Henri Becquerel, Rouen, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.affiliation: Hematology Department, Centre Henri Becquerel, Rouen, France. UMR INSERM U918, Centre Henri Becquerel, Rouen, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Jardin
authors.affiliation: Nuclear Medicine Department, Henri Becquerel Cancer Center and Rouen University Hospital, Rouen, France. QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Becker
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D005260:Female; D019788:Fluorodeoxyglucose F18; D020869:Gene Expression Profiling / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019788:Fluorodeoxyglucose F18