IELSG37: omission of radiotherapy in primary mediastinal B-cell lymphoma after a negative PET scan
Patients with primary mediastinal B-cell lymphoma whose PET scan was negative after immunochemotherapy did just as well without consolidation radiotherapy as with it, so radiotherapy can safely be omitted for them.
Overview
Phase 3 non-inferiority trial of 545 patients with primary mediastinal B-cell lymphoma treated with rituximab-containing immunochemotherapy; the 268 with a complete metabolic response on PET were randomised to observation or consolidation mediastinal radiotherapy.
Thirty-month progression-free survival was 96.2 percent with observation and 98.5 percent with radiotherapy, meeting non-inferiority, with overall survival of 99 percent in both arms.
- 30-month progression-free survival 96.2 percent (observation) vs 98.5 percent (radiotherapy); non-inferior.
- Overall survival 99 percent in both arms.
End-of-treatment PET now decides radiotherapy in primary mediastinal B-cell lymphoma: a negative scan means no radiotherapy, whichever chemotherapy regimen was used.
- Patients with residual PET uptake were not randomised and mostly received radiotherapy.
- Long-term second cancer data are pending.
Similar pages
not linked directly; found by shared links- Key paperKEYNOTE-170: pembrolizumab in relapsed or refractory primary mediastinal large B-cell lymphoma
Shares Primary mediastinal (thymic) large B-cell lymphoma, Journal of Clinical Oncology.
- TermDeauville five-point scale
Shares IELSG37, Primary mediastinal (thymic) large B-cell lymphoma.
- TermLugano classification / Ann Arbor staging
Shares IELSG37, Primary mediastinal (thymic) large B-cell lymphoma.
- TermR-CHOP (lymphoma chemoimmunotherapy)
Shares IELSG37, Primary mediastinal (thymic) large B-cell lymphoma.
- TechnologyPET-adapted (response-adapted) therapy
Shares IELSG37, Primary mediastinal (thymic) large B-cell lymphoma.
- TechnologyFDG PET
Shares IELSG37, Primary mediastinal (thymic) large B-cell lymphoma.