Prognostic role of FDG-PET in patients with relapsed/refractory large B-cell lymphoma treated with CD3-CD20 directed bispecific antibodies: a multicentric analysis

Wollnitza S, Ventura D, Teichert M, Freisleben F, Boyadzhiev H, Seifert R, Amon M, Barbato F, Scholz JK, Beck M, Kerkhoff A, Behringer A, Backhaus P, Pohlmann A, Schindler P, Roll W, Müller F, Novak U, Pabst T, Schäfers M, von Tresckow B, Shumilov E, Lenz G (2026)

Publication Type: Journal article

Publication year: 2026

Journal

European Journal of Nuclear Medicine and Molecular Imaging Springer Verlag (Germany)

DOI: 10.1007/s00259-026-07958-4

Abstract

Purpose: The clinical use of CD3–CD20–directed bispecific antibodies (BsAbs) has significantly improved outcomes of patients with relapsed/refractory LBCL. However, up to 50% of patients relapse. This study evaluated the prognostic value of longitudinal FDG-PET parameters. Methods: 58 patients with baseline PET and 45 (78%) with first PET after BsAb initiation were included. Standard PET metrics and Deauville score (DS) were recorded, with percent changes at follow-up defined as ΔPET parameters. Prognostic impact of DS and semi-quantitative PET metrics were determined for PFS/OS. Results: At baseline an whole-body MTV > 504.7 cm³ was associated with shorter median PFS of 1 vs. 3 months (HR = 5.6, P = 0.00025; C-index = 0.94). At first follow-up, those with DS4–5 exhibited significantly higher risk of progression (HR = 11.42, P = 0.0182; C-index = 0.97) and shorter survival (HR = 7.07, P = 0.059; C-index = 0.72). Non-achievement of ≥ 75.5% SUVmean reduction significantly increased risk for PFS (HR = 7.65; p = 0.0065; C-index = 0.92) and OS events (HR = 11.1; p = 0.001; C-index = 0.95). Conclusion: In summary, longitudinal semi-quantitative PET assessment identified patients at high risk of relapse and may enhance risk stratification and personalized management in BsAb-treated patients.

Authors with CRIS profile

Julia Scholz Department of Medicine 5 – Haematology and Oncology Michael Beck Department of Nuclear Medicine Fabian Müller Department of Medicine 5 – Haematology and Oncology

Involved external institutions

Universitätsklinikum Münster DE Germany (DE) Universitätsklinikum Essen DE Germany (DE) Inselspital, Universitätsspital Bern CH Switzerland (CH)

How to cite

APA:

Wollnitza, S., Ventura, D., Teichert, M., Freisleben, F., Boyadzhiev, H., Seifert, R.,... Lenz, G. (2026). Prognostic role of FDG-PET in patients with relapsed/refractory large B-cell lymphoma treated with CD3-CD20 directed bispecific antibodies: a multicentric analysis. European Journal of Nuclear Medicine and Molecular Imaging. https://doi.org/10.1007/s00259-026-07958-4

MLA:

Wollnitza, Sophie, et al. "Prognostic role of FDG-PET in patients with relapsed/refractory large B-cell lymphoma treated with CD3-CD20 directed bispecific antibodies: a multicentric analysis." European Journal of Nuclear Medicine and Molecular Imaging (2026).

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