Metabolic Imaging in B-Cell Lymphomas during CAR-T Cell Therapy

被引:13
作者
Linguanti, Flavia [1 ]
Abenavoli, Elisabetta Maria [1 ]
Berti, Valentina [1 ]
Lopci, Egesta [2 ]
机构
[1] Univ Florence, Dept Expt & Clin Biomed Sci Mario Serio, Nucl Med Unit, I-50134 Florence, Italy
[2] IRCCS Humanitas Res Hosp, Nucl Med Unit, Via Manzoni 56, I-20089 Rozzano, Italy
关键词
B-cell lymphoma; non-Hodgkin lymphoma; CAR-T; FDG; PET; CT; response; adverse events; TUMOR VOLUME; RESPONSE ASSESSMENT; ANTIGEN; PET; RECOMMENDATIONS; DIAGNOSIS; LEUKEMIA; HODGKIN;
D O I
10.3390/cancers14194700
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Chimeric antigen receptor-engineered T cells are an innovative therapy in hematologic malignancies, especially in patients with refractory/relapsed B-cell lymphomas. Few studies have analyzed the role of [F-18]FDG PET/CT in this field; this review aims to illustrate the literature data and the major findings related to [F-18]FDG PET/CT use during CAR-T cell therapy in B-cell lymphomas, focusing on the prognostic value of metabolic parameters, as well as on response assessment. Furthermore, this work shows in detail the specific adverse events during CAR-T cell therapy and the role of [F-18]FDG PET/CT imaging in their occurrence. Chimeric antigen receptor-engineered (CAR) T cells are emerging powerful therapies for patients with refractory/relapsed B-cell lymphomas. [F-18]FDG PET/CT plays a key role during staging and response assessment in patients with lymphoma; however, the evidence about its utility in CAR-T therapies for lymphomas is limited. This review article aims to provide an overview of the role of PET/CT during CAR-T cell therapy in B-cell lymphomas, focusing on the prognostic value of metabolic parameters, as well as on response assessment. Data from the literature report on the use of [F-18]FDG PET/CT at the baseline with two scans performed before treatment started focused on the time of decision (TD) PET/CT and time of transfusion (TT) PET/CT. Metabolic tumor burden is the most studied parameter associated with disease progression and overall survival, making us able to predict the occurrence of adverse effects. Instead, for post-therapy evaluation, 1 month (M1) PET/CT seems the preferable time slot for response assessment and in this setting, the Deauville 5-point scale (DS), volumetric analyses, SUVmax, and its variation between different time points ( increment SUVmax) have been evaluated, confirming the usefulness of M1 PET/CT, especially in the case of pseudoprogression. Additionally, an emerging role of PET/CT brain scans is reported for the evaluation of neurotoxicity related to CAR-T therapies. Overall, PET/CT results to be an accurate method in all phases of CAR-T treatment, with particular interest in assessing treatment response. Moreover, PET parameters have been reported to be reliable predictors of outcome and severe toxicity.
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页数:14
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