Status of FDG-PET as a biomarker

In November 2016, Josée M. Zijlstra from VU University Medical Center, Amsterdam, Netherlands, and colleagues published an editorial in Haematologica discussing the recent developments in the use of FDG-PET, particularly iPET, as a biomarker in both HL and DLBCL.

The authors stated that given the wealth of data from studies in patients with HL, FDG-PET is reliable for use as a biomarker for early response and that adapting therapy in light of FDG-PET is already becoming commonplace within clinical practice.

The authors also stated that, when it comes to DLBCL patients, it is crucial to identify treatment non-responsive patients early in order to maximize the efficacy of second-line therapies. Additionally, some studies indicate that iPET is effective at predicting outcome, but there are inconsistencies in the study designs and it is not clear which method of assessment is more effective. However, the PETRA consortium is conducting an ongoing meta-analysis of trials using different methods of assessing iPET (e.g. SUVmax, ΔSUV, etc.) in DLBCL patients.

In summary, FDG-PET has been shown to be a reliable biomarker in HL treatment, but it is unclear how effective FDG-PET or iPET are as biomarkers for early response in DLBCL, and which method of scoring is most effective.