Data from A Gene Expression–based Model to Predict Metabolic Response After Two Courses of ABVD in Hodgkin Lymphoma Patients

Abstract

<div>AbstractPurpose:<p>Early response to ABVD, assessed with interim FDG-PET (iPET), is prognostic for classical Hodgkin lymphoma (cHL) and supports the use of response adapted therapy. The aim of this study was to identify a gene-expression profile on diagnostic biopsy to predict iPET positivity (iPET<sup>+</sup>).</p>Experimental Design:<p>Consecutive untreated patients with stage I–IV cHL who underwent iPET after two cycles of ABVD were identified. Expression of 770 immune-related genes was analyzed by digital expression profiling (NanoString Technology). iPET was centrally reviewed according to the five-point Deauville scale (DS 1-5). An iPET<sup>+</sup> predictive model was derived by multivariate regression analysis and assessed in a validation set identified using the same inclusion criteria.</p>Results:<p>A training set of 121 and a validation set of 117 patients were identified, with 23 iPET<sup>+</sup> cases in each group. Sixty-three (52.1%), 19 (15.7%), and 39 (32.2%) patients had stage I–II, III, and IV, respectively. Diagnostic biopsy of iPET<sup>+</sup> cHLs showed transcriptional profile distinct from iPET<sup>−</sup>. Thirteen genes were stringently associated with iPET<sup>+</sup>. This signature comprises two functionally stromal-related nodes. Lymphocytes/monocytes ratio (LMR) was also associated to iPET<sup>+</sup>. In the training cohort a 5-gene/LMR integrated score predicted iPET<sup>+</sup> [AUC, 0.88; 95% confidence interval (CI), 0.80–0.96]. The score achieved a 100% sensitivity to identify DS5 cases. Model performance was confirmed in the validation set (AUC, 0.68; 95% CI, 0.52–0.84). Finally, iPET score was higher in patients with event versus those without.</p>Conclusions:<p>In cHL, iPET is associated with a genetic signature and can be predicted by applying an integrated gene-based model on the diagnostic biopsy.</p></div>