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Purpose <p>The clinical use of CD3–CD20–directed bispecific antibodies (BsAbs) has significantly improved outcomes of patients with relapsed/refractory LBCL. However, up to 50% of patients relapse. This study evaluated the prognostic value of longitudinal FDG-PET parameters.</p> Methods <p>58 patients with baseline PET and 45 (78%) with first PET after BsAb initiation were included. Standard PET metrics and Deauville score (DS) were recorded, with percent changes at follow-up defined as ΔPET parameters. Prognostic impact of DS and semi-quantitative PET metrics were determined for PFS/OS.</p> Results <p>At baseline an whole-body MTV &gt; 504.7&#xa0;cm³ was associated with shorter median PFS of 1 vs. 3 months (HR = 5.6, <i>P</i> = 0.00025; C-index = 0.94). At first follow-up, those with DS4–5 exhibited significantly higher risk of progression (HR = 11.42, <i>P</i> = 0.0182; C-index = 0.97) and shorter survival (HR = 7.07, <i>P</i> = 0.059; C-index = 0.72). Non-achievement of ≥ 75.5% SUVmean reduction significantly increased risk for PFS (HR = 7.65; <i>p</i> = 0.0065; C-index = 0.92) and OS events (HR = 11.1; <i>p</i> = 0.001; C-index = 0.95).</p> Conclusion <p>In summary, longitudinal semi-quantitative PET assessment identified patients at high risk of relapse and may enhance risk stratification and personalized management in BsAb-treated patients.</p>

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Prognostic role of FDG-PET in patients with relapsed/refractory large B-cell lymphoma treated with CD3-CD20 directed bispecific antibodies: a multicentric analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月1日

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  • Sophie Wollnitza,
  • David Ventura,
  • Marcel Teichert,
  • Fabian Freisleben,
  • Hristo Boyadzhiev,
  • Robert Seifert,
  • Michelle Amon,
  • Francesco Barbato,
  • Julia Katharina Scholz,
  • Michael Beck,
  • Andrea Kerkhoff,
  • Akhil Behringer,
  • Philipp Backhaus,
  • Alexander Pohlmann,
  • Philipp Schindler,
  • Wolfgang Roll,
  • Fabian Müller,
  • Urban Novak,
  • Thomas Pabst,
  • Michael Schäfers,
  • Bastian von Tresckow,
  • Evgenii Shumilov,
  • Georg Lenz

摘要

Purpose

The clinical use of CD3–CD20–directed bispecific antibodies (BsAbs) has significantly improved outcomes of patients with relapsed/refractory LBCL. However, up to 50% of patients relapse. This study evaluated the prognostic value of longitudinal FDG-PET parameters.

Methods

58 patients with baseline PET and 45 (78%) with first PET after BsAb initiation were included. Standard PET metrics and Deauville score (DS) were recorded, with percent changes at follow-up defined as ΔPET parameters. Prognostic impact of DS and semi-quantitative PET metrics were determined for PFS/OS.

Results

At baseline an whole-body MTV > 504.7 cm³ was associated with shorter median PFS of 1 vs. 3 months (HR = 5.6, P = 0.00025; C-index = 0.94). At first follow-up, those with DS4–5 exhibited significantly higher risk of progression (HR = 11.42, P = 0.0182; C-index = 0.97) and shorter survival (HR = 7.07, P = 0.059; C-index = 0.72). Non-achievement of ≥ 75.5% SUVmean reduction significantly increased risk for PFS (HR = 7.65; p = 0.0065; C-index = 0.92) and OS events (HR = 11.1; p = 0.001; C-index = 0.95).

Conclusion

In summary, longitudinal semi-quantitative PET assessment identified patients at high risk of relapse and may enhance risk stratification and personalized management in BsAb-treated patients.