https://www.theragnostics.no/en/author/niels-abildgaard/ Niels Abildgaard Hugo Blox Builder (https://hugoblox.com)en-usSun, 01 Oct 2023 00:00:00 +0000 https://www.theragnostics.no/media/icon_hu14557955862192370321.png https://www.theragnostics.no/en/author/niels-abildgaard/ https://www.theragnostics.no/en/publications/n%C3%B8rgaard-2023-intensifying/ Sun, 01 Oct 2023 00:00:00 +0000 https://www.theragnostics.no/en/publications/n%C3%B8rgaard-2023-intensifying/ <hr> <p>¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET) positivity after first-line treatment with autologous stem cell transplantation (ASCT) in multiple myeloma is strongly correlated with reduced progression-free and overall survival. However, PET-positive patients who achieve PET negativity after treatment seem to have comparable outcomes to patients who were PET negative at diagnosis. Hence, giving PET-positive patients additional treatment may improve their outcome. In this phase II study, we screened first-line patients with very good partial response (VGPR) or better after ASCT with PET. PET-positive patients received four 28-day cycles of carfilzomib-lenalidomide-dexamethasone (KRd). Flow cytometry-based minimal residual disease (MRD) analysis was performed before and after treatment for correlation with PET. Overall, 159 patients were screened with PET. A total of 53 patients (33%) were PET positive and 57% of PET-positive patients were MRD negative, demonstrating that these response assessments are complementary. KRd consolidation converted 33% of PET-positive patients into PET negativity. MRD-negative patients were more likely to convert than MRD-positive patients. In summary, PET after ASCT detected residual disease in a substantial proportion of patients in VGPR or better, even in patients who were MRD negative, and KRd consolidation treatment changed PET status in 33% of patients.</p>