Novel PET-Based Radiomics Signature Predicts CAR T Efficacy in DLBCL
A PET-based radiomics signature was able to predict the efficacy of chimeric antigen receptor (CAR) T-cell therapy and performed better than conventional PET biomarkers in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in a study published in eJHaem.
CAR T-cell therapy is an established third-line R/R DLBCL treatment. But not all patients see benefits from CAR T-cell therapy, and there is an unmet need to predictive biomarkers to help with patient selection, the study authors explained.
Certain qualitative imaging parameters have been associated with DLBCL outcomes, including F-fluorodeoxyglucose (FDG) positron emission tomography (PET)–based measures such as total metabolic tumor volume (TMTV) and the maximum standardized uptake value (SUVmax). The parameters are limited to tumor burden and maximum metabolic consumption, however, and they lack details about disease phenotype or the spatial distribution of the disease.
“PET-based radiomics provides quantitative imaging data regarding tumor shape, heterogeneity, and metabolic consumption distribution,” the authors wrote. “These parameters can provide insight into the tumor biology, including meaningful information about the cancer cell metabolism and tumor microenvironment for further identification of responsive phenotypes.” While prior studies have outlined PET-based radiomic features that are linked to treatment response in patients with DLBCL in the standard chemotherapy setting, data on PET-based radiomics in the CAR T-cell therapy setting are lacking.
The study assessed FDG-PET–based radiomic phenotypes in a cohort of patients with R/R DLBCL to determine which patients would benefit most from CAR T-cell therapy.
The PET-based radiomics signature indicates that larger lesions contribute to worse prognosis, and lesions with high SUVmax or negatively skewed distribution are also features associated with not benefiting from CAR T-cell therapy. The study was limited by a relatively small sample size in the validation cohort, but the authors consider the results encouraging and worth further exploration.
https://www.ajmc.com/view/novel-pet-based-radiomics-signature-predicts-car-t-efficacy-in-dlbcl
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