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@ARTICLE{Beck:300195,
      author       = {M. Beck and V. Blumenberg$^*$ and V. L. Bücklein and R. A.
                      Bundschuh and D. C. Harrer and K. Hirschbühl and J. Jung
                      and W. G. Kunz and K. Menhart and M. Winkelmann and I.
                      Yakushev and A. L. Illert and M. Eckstein and S. Völkl and
                      R. Claus and L. Hansmann and J. S. Hecker and T. Kuwert and
                      A. Mackensen and M. Subklewe$^*$ and D. Hellwig and F.
                      Müller},
      title        = {{L}iver-{FDG}-uptake augments early {PET}/{CT} prognostic
                      value for {CD}19-targeted {CAR}-{T} cell therapy in diffuse
                      large {B} cell lymphoma.},
      journal      = {EJNMMI Research},
      volume       = {15},
      number       = {1},
      issn         = {2191-219X},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-00672},
      pages        = {25},
      year         = {2025},
      abstract     = {Despite revolutionary efficacy of CD19-CAR-T cell therapy
                      (CAR-T) in aggressive B cell lymphoma, many patients still
                      relapse mostly early. In early failure, distinct drugs
                      support CAR-T which makes reliable and early prediction of
                      imminent relapse/refractoriness critical. A complete
                      metabolic remission (CR) on Fluor-18-Deoxyglucose (FDG)
                      Positron-Emission-Computed Tomography (PET) 30 days after
                      CAR-T (PET30) strongly predicts progression-free survival
                      (PFS), but still fails in a relevant proportion of patients.
                      We aimed to identify additional routine parameters in PET
                      evaluation to enhance CAR-T response prediction.Thirty
                      patients with aggressive B cell lymphoma treated with CAR-T
                      were retrospectively analyzed. Pre-CAR-T, LDH was the
                      strongest PFS-predictor also by multivariate analysis.
                      Post-CAR-T, 10 out of 14 patients $(71.4\%)$ with PET30-CR
                      remained in disease remission, while 12 out of 16 patients
                      $(75\%)$ with incomplete metabolic remission (PET30-nCR)
                      relapsed after CAR-T. $28.6\%$ of patients with PET30-CR
                      ultimately progressed. Change of liver FDG-uptake from
                      baseline to day30 (Delta-Liver-SUVmean) was identified as an
                      independent biomarker for response. PET30-nCR and a decrease
                      of Delta-Liver-SUVmean were associated with a high risk of
                      tumor progression (HR 4.79 and 3.99, respectively). The
                      combination of PET30 and Delta-Liver-SUVmean identified
                      patients at very low, at intermediate and at very high risk
                      of relapse (PFS not reached, 7.5 months, 1.5 months,
                      respectively).Additionally to PET30 metabolic remission,
                      longitudinal metabolic changes in Delta-Liver-SUVmean
                      predicted CAR-T efficiency. Our results may guide early
                      intervention studies aiming to enhance CAR-T particularly in
                      the very high-risk patients.},
      keywords     = {CAR T cell therapy (Other) / DLBCL (Other) / FDG PET
                      (Other) / Liver-SUV (Other)},
      cin          = {MU01},
      ddc          = {610},
      cid          = {I:(DE-He78)MU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40095158},
      pmc          = {pmc:PMC11914545},
      doi          = {10.1186/s13550-025-01201-1},
      url          = {https://inrepo02.dkfz.de/record/300195},
}