Pretreatment SUV_max may influence the clinical benefit of BR over R-CHOP in patients with previously untreated FL

Abstract

In 2 randomized phase 3 trials BR resulted in longer progression-free survival (PFS) than frontline R-CHOP in patients with indolent and mantle cell lymphoma. However, in subset analyses of follicular lymphoma (FL), the results were incongruent. We conducted a retrospective matched-pair analysis to compare the outcome of patients with advanced stage FL, receiving frontline BR (N = 73) or R-CHOP (N = 73), matched by age, gender, stage, and FL International Prognostic Index score. On multivariable analysis, baseline maximum standardized uptake value (SUV_max) >13 was associated with use of R-CHOP (p = .001). After a median follow-up of 69 months for the BR arm and 126 months for the R-CHOP arm, 5-year PFS was 80% and 70%, respectively (p = .07). After adjusting for SUV_max >13, the trend for better PFS in BR was not maintained. Prospective studies are needed to validate the role of pretreatment SUV_max as a stratification factor in future randomized therapeutic trials in FL.

Keywords:

• FL
• BR
• RCHOP
• SUV_max

Author contributions

PS designed the study, analyzed data, and wrote the paper; LJN, FBH, LEF, MAR, FS, MW, JRW, HJL, SI, SP, SA, RN, RES, CF, RED and NHF provided clinical care to patients and coauthored the paper; MAA and MN collected clinical data and coauthored the paper; LF provided statistical support and coauthored the paper; SN designed the study, analyzed the data, provided clinical care to patients, and wrote the paper.

Disclosure statement

SSN received research support from Kite/Gilead, Merck, BMS, Cellectis, Poseida, Karus, Acerta, and Unum Therapeutics. SSN served as Advisory Board Member/Consultant for Kite/Gilead, Merck, Celgene, Novartis, Unum Therapeutics, Pfizer, Precision Biosciences, Cell Medica, Allogene, Incyte, and Legend Biotech.

Additional information

Funding

This work was supported in part by The MD Anderson Cancer Center Support Grant (P30 CA016672).