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Article

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

1
Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service d’Hématologie Clinique, Hôpital Cochin, 75014 Paris, France
2
Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service de Médecine Nucléaire, Hôpital Cochin, 75014 Paris, France
3
Hôpital Marie Lannelongue, Service de Médecine Nucléaire, 92350 Le Plessis-Robinson, France
4
Assistance Publique-Hôpitaux de Paris Centre, Université de Paris, Service D’hémato-Biologie, Hôpital Cochin, 75014 Paris, France
*
Author to whom correspondence should be addressed.
Equal contribution to the work.
Academic Editors: Nicola Stefano Fracchiolla, Francesco Onida and Djordje Atanackovic
Cancers 2021, 13(17), 4323; https://doi.org/10.3390/cancers13174323
Received: 30 June 2021 / Revised: 25 August 2021 / Accepted: 25 August 2021 / Published: 27 August 2021
(This article belongs to the Special Issue Hematologic Malignancy)
Anti-CD38 monoclonal antibody has improved the prognosis of relapsed/refractory multiple myeloma (RRMM) but some patients still experience early relapse with a poor outcome. We have here evaluated the predictive value of FDG PET/CT parameters prior to receiving anti-CD38-based therapy in RRMM cases. In 38 consecutive patients, the median PFS was 12.5 months and the median OS was not reached. The presence of >3 focal lesions (FLs) on relapse PET (n = 19) and the initial ISS were associated with both an inferior PFS (p = 0.0036 and p = 0.0026) and OS (p = 0.025 and p = 0.0098). In multivariable analysis, the ISS and >3 FLs were independent prognostic factors for PFS (p = 0.010 and p = 0.025). A prognostic score combining the ISS (1,2, or 3 points) and >3 FL (1 point) individualized an ultra-risk group (scored 3–4) with a median PFS and OS of 3.1 months and 8.5 months respectively vs. not reached for patients scored 1–2. Combined with the ISS, the presence of >3 FLs on PET could improve the risk stratification of RRMM patients.
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. View Full-Text
Keywords: myeloma; immunotherapy; anti-CD38; FDG-PET/CT; prognostic factor; focal bone lesion myeloma; immunotherapy; anti-CD38; FDG-PET/CT; prognostic factor; focal bone lesion
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MDPI and ACS Style

Fouquet, G.; Wartski, M.; Dechmi, A.; Willems, L.; Deau-Fischer, B.; Franchi, P.; Descroocq, J.; Deschamps, P.; Blanc-Autran, E.; Clerc, J.; Bouscary, D.; Barreau, S.; Chapuis, N.; Vignon, M.; Cottereau, A.-S. Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy. Cancers 2021, 13, 4323. https://doi.org/10.3390/cancers13174323

AMA Style

Fouquet G, Wartski M, Dechmi A, Willems L, Deau-Fischer B, Franchi P, Descroocq J, Deschamps P, Blanc-Autran E, Clerc J, Bouscary D, Barreau S, Chapuis N, Vignon M, Cottereau A-S. Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy. Cancers. 2021; 13(17):4323. https://doi.org/10.3390/cancers13174323

Chicago/Turabian Style

Fouquet, Guillemette, Myriam Wartski, Amina Dechmi, Lise Willems, Bénédicte Deau-Fischer, Patricia Franchi, Justine Descroocq, Paul Deschamps, Estelle Blanc-Autran, Jérôme Clerc, Didier Bouscary, Sylvain Barreau, Nicolas Chapuis, Marguerite Vignon, and Anne-Ségolène Cottereau. 2021. "Prognostic Value of FDG-PET/CT Parameters in Patients with Relapse/Refractory Multiple Myeloma before Anti-CD38 Based Therapy" Cancers 13, no. 17: 4323. https://doi.org/10.3390/cancers13174323

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