Predicting survival, neurotoxicity and response in B-cell lymphoma patients treated with CAR-T therapy using an imaging features-based model

BackgroundThis multicentre retrospective observational study aims to develop imaging-based prognostic and predictive models for relapsed/refractory (R/R) B-cell lymphoma patients undergoing CAR-T therapy by integrating clinical data and imaging features. Specifically, our aim was to predict 3- and 6...

Descripción completa

Detalles Bibliográficos
Autores: Ferrer-Lores, B, Ortiz-Algarra, A, Picó-Peris, A, Estepa-Fernández, A, Bellvís-Bataller, F, Weiss, GJ, Fuster-Matanzo, A, Fernández, JP, Jimenez-Pastor, A, Hernani, R, Saus-Carreres, A, Benzaquen, A, Ventura, L, Piñana, JL, Teruel, AB, Serrano-Alcalá, A, Dosdá, R, Sopena-Novales, P, Balaguer-Rosello, A, Guerreiro, M, Sanz, J, Marti-Bonmatí, L, Terol, MJ, Alberich-Bayarri, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p19294
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/19294
Access Level:acceso abierto
Palabra clave:CAR-T cells therapy
Non-Hodgkin lymphoma
Radiomics
Survival prediction
ICANS prediction
Treatment response prediction
Descripción
Sumario:BackgroundThis multicentre retrospective observational study aims to develop imaging-based prognostic and predictive models for relapsed/refractory (R/R) B-cell lymphoma patients undergoing CAR-T therapy by integrating clinical data and imaging features. Specifically, our aim was to predict 3- and 6-month treatment response, overall survival (OS), progression-free survival (PFS), and the occurrence of the immune effector cell-associated neurotoxicity syndrome (ICANS).ResultsSixty-five patients of R/R B-cell lymphoma treated with CAR-T cells in two centres were included. Pre-infusion [18F]FDG PET/CT scans and clinical data were systematically collected, and imaging features, including kurtosis, entropy, maximum diameter, standardized uptake value (SUV) related features (SUVmax, SUVmean, SUVstd, SUVmedian, SUVp25, SUVp75), total metabolic tumour volume (MTVtotal), and total lesion glycolysis (TLGtotal), were extracted using the Quibim platform. The median age was 62 (range 21-76) years and the median follow-up for survivors was 10.47 (range 0.20-45.80) months. A logistic regression model accurately predicted neurotoxicity (AUC: 0.830), and Cox proportional-hazards models for CAR-T response at 3 and 6 months demonstrated high accuracy (AUC: 0.754 and 0.818, respectively). Median predicted OS after CAR-T therapy was 4.73 months for high MTVtotal and 37.55 months for low MTVtotal. Median predicted PFS was 2.73 months for high MTVtotal and 11.83 months for low MTVtotal. For all outcomes, predictive models, combining imaging features and clinical variables, showed improved accuracy compared to models using only clinical variables or imaging features alone.ConclusionThis study successfully integrates imaging features and clinical variables to predict outcomes in R/R B-cell lymphoma patients undergoing CAR-T. Notably, the identified MTVtotal cut-off effectively stratifies patients, as evidenced by significant differences in OS and PFS. Additionally, the predictive models for neurotoxicity and CAR-T response show promising accuracy. This comprehensive approach holds promise for risk stratification and personalized treatment strategies which may become a helpful tool for optimizing CAR-T outcomes in R/R lymphoma patients.

Similares en LA Referencia