Imaging frequency has no impact on PFS for patients with follicular lymphoma
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CHICAGO — The performance of less frequent imaging and bone marrow biopsies than required by clinical trials in patients with follicular lymphoma did not impact PFS, according to data presented at ASCO Annual Meeting.
“We do conclude from this that we should consider decreasing the imaging requirements in clinical trials enrolling patients with follicular lymphoma,” Sarah Rutherford, MD, assistant professor of medicine in the division of hematology/oncology at Weill Cornell Medicine, said during her presentation.
By investigating and identifying the trials by Alliance for Clinical Trials in Oncology that enrolled untreated patients with follicular lymphoma from 2008-2016, this study was able to hypothesize how PFS would not be different when imaging is performed less often than required by trials.
“There are a lot of reasons why imaging studies have some negative factors in management of patients with lymphoma. Some of those are the anxiety for patients related to undergoing scans, radiation exposure that can increase risk [for] other cancers, and they're expensive,” Rutherford said.
The two imaging schedules used in this study were protocol specified (control) and relaxed (X). The control schedule required one scan every 4 months for the first 2 years and every 6 months ongoing for up to 10 years. Schedule X imaging responses at every other required time point were omitted.
In each trial, researchers estimated PFS using Kaplan Meier methods for the two schedules, then determined difference in PFS between schedules as percentage change from control schedule in a 2-year PFS rate.
“So basically, we did the scans half as often. We then compared the 2-year and 4-year PFS difference between those schedules. The control schedule is what we call the one that was that was defined by the protocol. Schedule X found very minimal difference between the progression free survival at 2 years and 4 years in these two different schedules. This supports doing scans less frequently.”
The total number of patients looked at was 321. By performing simulation studies, researchers could get a larger projection of what the impact of different imaging schedules would be.
“We looked again at the standard imaging that was done on the clinical trials compared with three different schedules. Looking at decreasing frequency of imaging studies, again, we found that the progression free survival in this case was very similar among the different schedules,” Rutherford said.
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Rutherford S, et al. Abstract 7520. Presented at: ASCO Annual Meeting; June 2-6, 2022; Chicago.
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