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Objective: The addition of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) to endocrine therapy impressively improved the outcome of patients with hormone receptor-positive metastatic breast cancer. Despite their great efficacy, not all patients respond to treatment and many of them develop acquired resistance. The aim of this retrospective study was to assess the role of [18F]-FDG PET/CT in predicting PFS and OS in breast cancer patients treated with CDK4/6i. Methods: 114 patients who performed an [18F]-FDG PET/CT scan before (PET1) and 2-6 months (PET2) after starting treatment were retrospectively enrolled. Metabolic response was evaluated by EORTC, PERCIST and Deauville Score and correlated to PFS and OS. Results: In patients who did not progress at PET2 (n = 90), PFS rates were not significantly different between classes of response by EORTC and PERCIST. Conversely, patients showing a Deauville score =3 had a longer PFS (median PFS 42 vs 21.0 months; p = 0.008). A higher total metabolic tumor volume at PET1 (TMTV1) was also associated with a shorter PFS (median 18 vs 42 months; p = 0.0026). TMTV1 and Deauville score were the only independent prognostic factors for PFS at multivariate analysis and their combination stratified the population in four definite classes of relapse risk. Conversely, the above parameters did not affect OS which was only influenced by a progressive metabolic disease at PET2 (3-years survival rate 29.8 vs 84.9%; p<0.0001). Conclusion: TMTV and metabolic response by Deauville score were significant prognostic factors for PFS in patients with breast cancer treated with CDK4/6i. Their determination could help physicians to select patients who may need a closer follow up. [ABSTRACT FROM AUTHOR]

ObjectiveThe addition of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) to endocrine therapy impressively improved the outcome of patients with hormone receptor-positive metastatic breast cancer. Despite their great efficacy, not all patients respond to treatment and many of them develop acquired resistance. The aim of this retrospective study was to assess the role of [18F]-FDG PET/CT in predicting PFS and OS in breast cancer patients treated with CDK4/6i.Methods114 patients who performed an [18F]-FDG PET/CT scan before (PET1) and 2-6 months (PET2) after starting treatment were retrospectively enrolled. Metabolic response was evaluated by EORTC, PERCIST and Deauville Score and correlated to PFS and OS.ResultsIn patients who did not progress at PET2 (n = 90), PFS rates were not significantly different between classes of response by EORTC and PERCIST. Conversely, patients showing a Deauville score ≤3 had a longer PFS (median PFS 42 vs 21.0 months; p = 0.008). A higher total metabolic tumor volume at PET1 (TMTV1) was also associated with a shorter PFS (median 18 vs 42 months; p = 0.0026). TMTV1 and Deauville score were the only independent prognostic factors for PFS at multivariate analysis and their combination stratified the population in four definite classes of relapse risk. Conversely, the above parameters did not affect OS which was only influenced by a progressive metabolic disease at PET2 (3-years survival rate 29.8 vs 84.9%; p

This study's focus is the association of end-of-therapy (EOT) PET results with progression-free (PFS) and overall survival (OS) in patients with diffuse large B-cell lymphoma receiving first-line chemoimmunotherapy. We develop a Bayesian hierarchical model for predicting PFS and OS from EOT PET-complete response (PET-CR) using a literature-based meta-analysis of 20 treatment arms and a substudy of 4 treatment arms in 3 clinical trials for which we have patient-level data. The PET-CR rate in our substudy was 72%. The modeled estimates for hazard ratio (PET-CR/non-PET-CR) were 0.13 for PFS (95% CI 0.10, 0.16) and 0.10 for OS (CI 0.07, 0.12). Hazard ratios varied little by patient subtype and were confirmed by the overall meta-analysis. We link these findings to designing future clinical trials and show how our model can be used in adapting the sample size of a trial to accumulating results regarding treatment benefits on PET-CR and a survival endpoint. [ABSTRACT FROM AUTHOR]

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Introduction: Recently published unfavourable results of endoscopic radical surgery for early-stage cervical cancer compared to open surgery raises the need for auditing treatment results of endoscopic staging surgery for endometrial cancer. Aim: Comparison of progression-free and overall survival (PFS and OS) between endometrial cancer patients treated with laparoscopic (LSC) and open surgical techniques. Method: Retrospective analysis was performed to compare clinicopathological and survival data of endometrial cancer patients who had either laparoscopic or open staging surgery between 2013 and 2019 at the Gynaecological Oncology Unit of the University of Debrecen, Hungary. Distribution of the most relevant prognostic factors were compared with χ 2 and t -tests. Frequencies of progressive disease and disease-specific deaths were compared in the Cox-model, while progression-free and overall survival curves were compared with the Kaplan-Meier method. Results: The frequency of endometrioid, serous papillary, mixed Müllerian, adenosquamous and other histological types in the laparoscopic and open groups were similar (p = 0.3356). The frequency of grade 1, 2 and 3 tumours in the endoscopic and open groups showed significant differences (p = 0.0036). Pathological stage-distribution (IA, IB, II, IIIA, IIIB, IIIC1, IIIC2) of endoscopic cases and open cases was also statistically different (p = 0.0048). The mean number of removed lymph-nodes was higher in the open surgery group (14.3 vs. 9,3, p<0.0001). The frequency of recurrence did not show significant difference between the two groups, in contrast to the frequency of disease-specific deaths (2/120 vs. 29/345, p = 0.01; 2/120 vs. 17/345, p = 0.12). In the Cox-model, progression-free survival and overall survival showed a hazard ratio favouring laparoscopic surgery, however, the range of 95% confidence intervals showed no statistical significance (PFS LSC vs. open: HR = 0.36, 95% CI = 0.084-1.538; OS LSC vs. open: HR = 0.603, 95% CI = 0.135-2.693). Conclusion: Progression-free and overall survival of endoscopically staged endometrial cancer is not worse than those of patients staged with open surgery. Orv Hetil. 2020; 161(10): 382-388.