The Link between Cytogenetics/Genomics and Imaging Patterns of Relapse and Progression in Patients with Relapsed/Refractory Multiple Myeloma: A Pilot Study Utilizing 18F-FDG PET/CT

Zhou, Xiang; Dierks, Alexander; Kertels, Olivia; Samnick, Samuel; Kircher, Malte; Buck, Andreas K.; Haertle, Larissa; Knorz, Sebastian; Böckle, David; Scheller, Lukas; Messerschmidt, Janin; Barakat, Mohammad; Truger, Marietta; Haferlach, Claudia; Einsele, Hermann; Rasche, Leo; Kortüm, K. Martin; Lapa, Constantin

doi:10.3390/cancers12092399

Cited by 6 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another explanation may have been prognostic improvements among these cases due to anti-CD38 therapy. By contrast to the report of Zhou et al, we did not find a high SUVmax in patients harboring del(17p) compared with those without this abnormality [30]. At baseline, a high bone SUVmax has been suggested to be a prognostic indicator [31].…”

Section: Discussioncontrasting

confidence: 99%

Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy

Fouquet

Dechmi

Willems

et al. 2021

Cancers

View full text Add to dashboard Cite

Although anti-CD38 monoclonal antibodies have improved the prognosis of relapsed/refractory multiple myeloma (RRMM), some patients still experience early relapses with poor outcomes. This present study evaluated the predictive value of FDG PET/CT parameters for RRMM prior to initiating anti-CD38 treatment. We included 38 consecutive RRMM patients who underwent a PET/CT scan treated at our institution at relapse. The median PFS was 12.5 months and the median OS was not reached. 42% of the patients had an initial ISS score of 1, 37% of 2, and 21% of 3. The presence of >3 focal lesions (FLs, n = 19) and the ISS score were associated with inferior PFS (p = 0.0036 and p = 0.0026) and OS (p = 0.025 and p = 0.0098). Patients with >3 FLs had a higher initial ISS score (p = 0.028). In multivariable analysis, the ISS score and >3 FLs were independent prognostic factors for PFS (p = 0.010 and p = 0.025 respectively), and combined they individualized a high-risk group with a median PFS and OS of 3.1 months and 8.5 months respectively vs. not reached for the other patients. The presence of >3 FLs on PET was predictive of survival outcomes in patients with RRMM treated using CD38 targeted therapy. Combined with the initial ISS, an ultra-high-risk RRMM population can thus be identified.

show abstract

Section: Discussioncontrasting

confidence: 99%

Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy

Fouquet

Dechmi

Willems

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…It has to be underlined that, although MET showed superior diagnostic performance with respect to FDG for MM staging and post-treatment evaluation, FDG maintained a prognostic impact to predict survival in relapsing patients and correlated with high-risk cytogenetic [ 22 , 28 , 29 ]. It is worth mentioning that MET and FDG provide different and complementary information since they reflect distinct metabolic pathways.…”

Section: Discussionmentioning

confidence: 99%

Head-to-Head Comparison between FDG and 11C-Methionine in Multiple Myeloma: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

The aim of this systematic review is to provide a comprehensive overview of the existing literature, comparing 18F-fluorodeoxyglucose (FDG) and 11C-methionine (MET) for the imaging of multiple myeloma (MM) with positron emission computed tomography (PET/CT). Relevant studies published from 2013 up to March 2023 were selected by searching Scopus, PubMed, and Web of Science. Selected imaging studies were analyzed using a modified version of the critical Appraisal Skills Programme (CASP). Ten studies encompassing 335 patients were selected. On a patient-based analysis, MET sensitivity ranged between 75.6% and 100%, resulting higher than that measured for FDG (0–100%). MET outperformed FDG for the detection of focal lesions, diffuse bone marrow involvement and mixed patterns. PET-derived parameters resulted higher for MET than for FDG, with a strong correlation with clinical variables (e.g., monoclonal component and beta-2-microglobulin levels, bone marrow infiltration, etc.), although FDG maintained a prognostic impact on outcome prediction. When compared to other tracers or imaging modalities, MET showed stronger correlation and inter-observer agreement than FDG. Although biased by the small cohorts and requiring confirmation through multicenter studies, preliminary findings suggest that MET–PET should be preferred to FDG for PET imaging of MM, or alternatively used as a complementary imaging modality. Some issues, such as tracer availability and the role of MET with respect to other emerging tracers (i.e., 68Ga-pentixafor, 18F-FACBC and 18F-FET), should be the topic of further investigations.

show abstract

“…HRCA was identified from different BM sites at the same time in 25% of patients diagnosed with non HRCA [ 144 ]. High uptake using fluorodeoxyglucose (FDG)-PET/CT was associated with HRCA [ 145 ]. Genomic instability is associated with increasing driver mutations, loss of heterozygosity (LOH), and APOBEC signatures and predicts poor prognosis [ 144 , 146 , 147 ].…”

Section: Clonal Evolutionmentioning

confidence: 99%

Treatment Strategies Considering Micro-Environment and Clonal Evolution in Multiple Myeloma

Suzuki

Nishiwaki

Yano

2021

Cancers

View full text Add to dashboard Cite

Multiple myeloma is an uncurable hematological malignancy because of obtained drug resistance. Microenvironment and clonal evolution induce myeloma cells to develop de novo and acquired drug resistance, respectively. Cell adhesion-mediated drug resistance, which is induced by the interaction between myeloma and bone marrow stromal cells, and soluble factor-mediated drug resistance, which is induced by cytokines and growth factors, are two types of de novo drug resistance. The microenvironment, including conditions such as hypoxia, vascular and endosteal niches, contributes toward de novo drug resistance. Clonal evolution was associated with acquired drug resistance and classified as branching, linear, and neutral evolutions. The branching evolution is dependent on the microenvironment and escape of immunological surveillance while the linear and neutral evolution is independent of the microenvironment and associated with aggressive recurrence and poor prognosis. Proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), monoclonal antibody agents (MoAbs), and autologous stem cell transplantation (ASCT) have improved prognosis of myeloma via improvement of the microenvironment. The initial treatment plays the most important role considering de novo and acquired drug resistance and should contain PIs, IMIDs, MoAb and ASCT. This review summarizes the role of anti-myeloma agents for microenvironment and clonal evolution and treatment strategies to overcome drug resistance.

show abstract

The Link between Cytogenetics/Genomics and Imaging Patterns of Relapse and Progression in Patients with Relapsed/Refractory Multiple Myeloma: A Pilot Study Utilizing 18F-FDG PET/CT

Cited by 6 publications

References 27 publications

Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy

Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy

Head-to-Head Comparison between FDG and 11C-Methionine in Multiple Myeloma: A Systematic Review

Treatment Strategies Considering Micro-Environment and Clonal Evolution in Multiple Myeloma

Contact Info

Product

Resources

About