Publications by authors named "Lugtenburg P"

Patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) have poor outcomes. Gemcitabine + oxaliplatin (GemOx) with rituximab, a standard salvage therapy, yields complete response (CR) rates of approximately 30% and median overall survival (OS) of 10-13 months. Patients with refractory disease fare worse, with a CR rate of 7% for subsequent therapies and median OS of 6 months.

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Next Generation Sequencing-based subtyping and interim- and end of treatment positron emission tomography (i/eot-PET) monitoring have high potential for upfront and on-treatment risk assessment of diffuse large B-cell lymphoma patients. We performed Dana Farber Cancer Institute (DFCI) and LymphGen genetic subtyping for the HOVON84 (n = 208, EudraCT-2006-005174-42) and PETAL (n = 204, EudraCT-2006-001641-33) trials retrospectively combined with DFCI genetic data (n = 304). For all R-CHOP treated patients (n = 592), C5/MCD- and C2/A53-subtypes show significantly worse outcome independent of the international prognostic index.

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Background: Bleomycin is an oncolytic and antibiotic agent used to treat various human cancers because of its antitumor activity. Unfortunately, up to 46% of the patients treated with bleomycin develop drug-induced interstitial lung disease (DIILD) and potentially life-threatening interstitial pulmonary fibrosis. Tools and biomarkers for predicting and detecting DIILD are limited.

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Article Synopsis
  • The study aimed to validate a deep learning model for predicting treatment outcomes in diffuse large B-cell lymphoma patients across 5 clinical trials, comparing it to the international prognostic index (IPI) and radiomic models.
  • The deep learning model, trained on PET/CT scans, demonstrated a higher predictive performance (AUC of 0.66) than IPI (AUC of 0.60) and performed well across all trials.
  • While the deep learning and clinical PET models showed similar performance (AUC of 0.69), the PET model achieved the highest AUC (0.71), although the deep learning model provided outcomes without requiring tumor delineation.
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  • Epcoritamab, a bispecific antibody targeting CD3 and CD20, showed promising long-term results as a monotherapy for relapsed or refractory large B-cell lymphoma (LBCL) in the EPCORE NHL-1 study, with a 63.1% overall response rate and a 40.1% complete response rate after a median follow-up of 25.1 months.
  • The estimated 24-month progression-free survival (PFS) and overall survival (OS) rates were 27.8% and 44.6%, respectively, with 64.2% of complete responders maintaining their response at that time.
  • Most treatment-emergent adverse events were manageable, with cytokine release syndrome
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First-line treatment for advanced-stage diffuse large B-cell lymphoma (DLBCL) typically involves 6x R-CHOP21 or 6x R-CHOP21 with two additional rituximab administrations (6x R-CHOP21 + 2 R). In contemporary practice, this treatment choice might be guided by interim PET scan results. This nationwide, population-based study investigates the comparative effectiveness of these treatment regimens in an era where interim PET-guided treatment decisions were not standard practice.

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  • This study aimed to assess the effectiveness of epcoritamab, a new bispecific antibody, for treating patients with advanced follicular lymphoma who have already undergone multiple previous therapies.
  • The research was part of the EPCORE NHL-1 trial, which took place at 88 sites across 15 countries and involved patients aged 18 and older with specific eligibility criteria, including having received at least two prior treatments.
  • Treatment involved subcutaneous injections of epcoritamab in cycles, with a tailored dosing strategy to minimize the risk of cytokine release syndrome, and the primary focus was on evaluating the overall response rate and safety measures related to cytokine release.
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Purpose: Female Hodgkin lymphoma (HL) survivors treated with chest radiotherapy (RT) at a young age have a strongly increased risk of breast cancer (BC). Studies in childhood cancer survivors have shown that doxorubicin exposure may also increase BC risk. Although doxorubicin is the cornerstone of HL chemotherapy, the association between doxorubicin and BC risk has not been examined in HL survivors treated at adult ages.

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Article Synopsis
  • A study evaluated patient-reported outcomes in adults with relapsed or refractory large B-cell lymphoma treated with epcoritamab, a new monotherapy.
  • Patients completed assessments to measure quality of life and symptoms, and the results showed significant improvements in their scores over the treatment period.
  • The majority of patients expressed satisfaction with the treatment, highlighting its potential effectiveness in enhancing their quality of life.
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Background: Patients with newly diagnosed high-risk Burkitt lymphoma are treated with high-intensity immune-chemotherapy regimens such as R-CODOX-M/R-IVAC or with lower-intensity regimens such as DA-EPOCH-R. The aim of this study was to make a formal comparison between these regimens.

Methods: This multicentre, phase 3, open-label, randomised study was done in 26 clinical centres in the Netherlands, Belgium, and Switzerland.

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Article Synopsis
  • CAR-T therapy outcomes for relapsed/refractory large B-cell lymphoma vary by country, with the Netherlands having a structured system for patient assessment and data collection.
  • In a study involving 250 patients from May 2020 to May 2022, 145 received axicabtagene ciloleucel, showing high response rates (84%) and improvements in health-related quality of life after nine months.
  • While results are promising, significant unmet medical needs remain for many patients, indicating room for further improvement and research into effective treatments.
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Convolutional neural networks (CNNs) may improve response prediction in diffuse large B-cell lymphoma (DLBCL). The aim of this study was to investigate the feasibility of a CNN using maximum intensity projection (MIP) images from F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) baseline scans to predict the probability of time-to-progression (TTP) within 2 years and compare it with the International Prognostic Index (IPI), i.e.

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CD19-directed chimeric antigen receptor (CAR) T-cell therapy has had a dramatic impact on the natural history and survival of patients with high-risk B-cell non-Hodgkin lymphoma. Accompanying this success has been the development of new fields of medicine and investigation into toxicity risks and mitigation therapies, mechanisms of resistance and the development of novel and next generation products and strategies in order to address relapse, and issues related to global access and health care economics. This article is a survey of each of these areas as it pertains to the rapidly evolving field of CAR T-cell therapy, written by an International community of lymphoma experts, who also happen to be women.

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The objective of this study is to externally validate the clinical positron emission tomography (PET) model developed in the HOVON-84 trial and to compare the model performance of our clinical PET model using the international prognostic index (IPI). In total, 1195 patients with diffuse large B-cell lymphoma (DLBCL) were included in the study. Data of 887 patients from 6 studies were used as external validation data sets.

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Article Synopsis
  • Epcoritamab is a bispecific antibody that helps T cells attack and kill malignant B cells, showing strong results in treating B-cell non-Hodgkin lymphoma during previous trials.
  • In a phase I/II study, patients with relapsed or refractory large B-cell lymphoma received weekly doses of epcoritamab for up to several months to assess its effectiveness.
  • Results showed a 63.1% overall response rate and 38.9% complete response rate among 157 patients with manageable side effects, suggesting it is a promising treatment for difficult cases of lymphoma.
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Purpose: Prompt recognition of acute chimeric antigen receptor T (CAR T)-cell-mediated toxicities is crucial because adequate and timely management can prevent or reverse potential life-threatening complications. In the outpatient setting, patients and informal caregivers have to recognize and report signs and symptoms marking these acute toxicities. This study provides a core set of patient- and caregiver-reported signs and symptoms (outcomes, P/CROs) and definitions of red flags warranting immediate action to include in a daily checklist for support at home, with the goal to make outpatient post-CAR T-cell care safer, optimize patient and caregiver support, and thereby facilitating an early discharge/hospital visit reduction strategy.

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  • Diffuse large B-cell lymphoma (DLBCL) is a serious type of cancer that's easier to treat in older people, especially with the right medication called Rituximab-CHOP.
  • Doctors need to think about how strong each older patient is before deciding on treatment, using simple tests like walking speed and grip strength.
  • For older or weaker patients, doctors may use gentler methods or different medicines instead of traditional chemotherapy to help them avoid serious side effects.
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  • The study aimed to enhance outcome prediction in patients with aggressive B-cell lymphoma by integrating clinical, molecular, and radiomic features.
  • Researchers focused on specific genetic markers (MYC, BCL2, BCL6) and analyzed 17 radiomics features from PET-CT scans of 323 patients, using logistic regression to assess progression after 2 years.
  • The findings showed that combining traditional models like the International Prognostic Index (IPI) with radiomic data significantly improved predictive accuracy, with the best model yielding a positive predictive value of 50%, indicating its effectiveness in identifying patients at higher risk of poor outcomes.
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Risk-stratified treatment strategies have the potential to increase survival and lower toxicity in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) patients. This study investigated the prognostic value of serum (s)TARC, vitamin D and lactate dehydrogenase (LDH), TARC immunohistochemistry and quantitative PET parameters in 65 R/R cHL patients who were treated with brentuximab vedotin (BV) and DHAP followed by autologous stem-cell transplantation (ASCT) within the Transplant BRaVE study (NCT02280993). At a median follow-up of 40 months, the 3-year progression free survival (PFS) was 77% (95% CI: 67-88%) and the overall survival was 95% (90-100%).

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Background: Hodgkin lymphoma survivors treated with infradiaphragmatic radiotherapy (IRT) and/or procarbazine have an increased risk of developing colorectal cancer. We investigated the cost-effectiveness of colorectal cancer surveillance in Dutch Hodgkin lymphoma survivors to determine the optimal surveillance strategy for different Hodgkin lymphoma subgroups.

Methods: The Microsimulation Screening Analysis-Colon model was adjusted to reflect colorectal cancer and other-cause mortality risk in Hodgkin lymphoma survivors.

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Introduction: Although visual and quantitative assessments of [18F]FDG PET/CT studies typically rely on liver uptake value as a reference or normalisation factor, consensus or consistency in measuring [18F]FDG uptake is lacking. Therefore, we evaluate the variation of several liver standardised uptake value (SUV) measurements in lymphoma [18F]FDG PET/CT studies using different uptake metrics.

Methods: PET/CT scans from 34 lymphoma patients were used to calculate SUVmax, SUVpeak and SUVmean as a function of (1) volume-of-interest (VOI) size, (2) location, (3) imaging time point and (4) as a function of total metabolic tumour volume (MTV).

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Purpose: Previous efforts to predict absolute risk of treatment-related cardiovascular diseases (CVDs) have mostly focused on childhood cancer survivors. We aimed to develop prediction models for risk of coronary heart disease (CHD) and heart failure (HF) for survivors of adolescent/adult Hodgkin lymphoma (HL).

Methods: For model development, we used a multicenter cohort including 1,433 5-year HL survivors treated between 1965 and 2000 and age 18-50 years at HL diagnosis, with complete data on administered chemotherapy regimens, radiotherapy volumes and doses, and cardiovascular follow-up.

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