FLIPI24: A Modern Prognostic Model and Clinical Trial Enrichment Tool for Newly Diagnosed Follicular Lymphoma

Matthew J Maurer; Vit K Prochazka; Tarec Christoffer El-Galaly; Christopher R Flowers; Diego Villa; Emmanuel Bachy; Elliot J Cahn; Marguerite Fournier; Melissa C Larson; Caroline E Dietrich; Lasse Hjort Jakobsen; Hervé Ghesquières; Robert Kridel; Maher K Gandhi; Chan Y Cheah; Eliza A Hawkes; John F Seymour; Ciara L Freeman; Michael R Clausen; Björn E Wahlin; Jonathan W Friedberg; Carla Casulo; Thomas M Habermann; Yucai Wang; Loretta J Nastoupil; Peter de Nully Brown; David Belada; Andrea Janíková; Heidi Mocikova; Tomáš Fürst; Pierre Feugier; Hervé Tilly; Corinne Haioun; Andrew J Davies; Guillaume Cartron; Richard Burack; Dai Chihara; Peter Martin; Jonathon B Cohen; Izidore S Lossos; Brad S Kahl; Laurie H Sehn; Karin E Smedby; Gilles Salles; Marek Trneny; Brian K Link; Franck Morschhauser; James R Cerhan

doi:10.1200/JCO-25-00892

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FLIPI24: A Modern Prognostic Model and Clinical Trial Enrichment Tool for Newly Diagnosed Follicular Lymphoma

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FLIPI24: A Modern Prognostic Model and Clinical Trial Enrichment Tool for Newly Diagnosed Follicular Lymphoma

Matthew J Maurer, Vit K Prochazka, Tarec Christoffer El-Galaly, Christopher R Flowers, Diego Villa, Emmanuel Bachy, Elliot J Cahn, Marguerite Fournier, Melissa C Larson, Caroline E Dietrich, …

Journal of clinical oncology, p.JCO2500892

02/12/2025

DOI: https://doi.org/10.1200/JCO-25-00892

PMID: 41329901

Résumé

Although most patients with follicular lymphoma (FL) can expect an indolent course, progressive lymphoma remains the primary cause of death during the first decade after diagnosis. Progression of disease within 24 months (POD24) of starting first-line (1L) immunochemotherapy defines a high-risk population with poor survival, but better risk stratification at diagnosis is needed. The FLIPI24 model was developed and internally validated to predict 24-month event rates using individual data from 4,485 patients treated with 1L immunochemotherapy from 10 observational cohorts of FL. Overall and cause-specific survival was further evaluated in FLIPI24 risk groups. External validation in the 1L immunochemotherapy setting was performed using the prospective observational Lymphoma Epidemiology of Outcomes (LEO) cohort (N = 565) and three randomized phase III trials (N = 3,192); extension to all patients with FL (any 1L therapy) was performed in the LEO cohort (N = 1,445) and its Molecular Epidemiology Resource subcohort (N = 1,074). The FLIPI24 model uses age and four blood-based variables (hemoglobin, lactate dehydrogenase, beta-2 microglobulin, and WBC count). FLIPI24 showed consistent performance across validation and extension data sets, which was superior to existing prognostic tools. Across the four external immunochemotherapy validation data sets, patients with high-risk FLIPI24 (23%-32% of patients) had significantly higher 24-month event rates (22%-35%) and inferior 5-year overall survival (77%-83%) compared with patients with low-risk FLIPI24 (29%-31% of patients, 24-month event rates: 10%-12%; 5-year OS: 96%-97%). Results were consistent when evaluating lymphoma-related death and when extended to all patients with FL. The FLIPI24 model robustly stratifies, at diagnosis, patients with FL at increased risk of lymphoma-related death versus patients with very low lymphoma-related mortality during the first decade after diagnosis. FLIPI24 can be used to enrich future clinical trial designs in newly diagnosed FL.

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Titre: FLIPI24: A Modern Prognostic Model and Clinical Trial Enrichment Tool for Newly Diagnosed Follicular Lymphoma
Créateurs - sans rôle: Matthew J Maurer - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
Vit K Prochazka - Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University and University Hospital Olomouc, Olomouc, Czech Republic
Tarec Christoffer El-Galaly - Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
Christopher R Flowers - Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
Diego Villa - BC Cancer Centre for Lymphoid Cancer and University of British Columbia, Vancouver, BC, Canada
Emmanuel Bachy - Department of Hematology, Lyon Sud Hospital, Lyon, France
Elliot J Cahn - Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
Marguerite Fournier - Department of Biometry, Lymphoma Study Association Clinical Research (LYSARC), Hopital Lyon Sud, Pierre Benite, France
Melissa C Larson - Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
Caroline E Dietrich - Division of Clinical Epidemiology, Dept of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
Lasse Hjort Jakobsen - Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
Hervé Ghesquières - Hôpital Lyon Sud
Robert Kridel - Princess Margaret Cancer Centre-UHN, Toronto, Ontario, Canada
Maher K Gandhi - Mater Research Institute University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
Chan Y Cheah - Medical School, University of Western Australia, Perth, Australia
Eliza A Hawkes - Olivia Newton John Cancer Research Institute at Austin Health, Melbourne, Australia
John F Seymour - The University of Melbourne
Ciara L Freeman - Department of Blood and Marrow Transplantation and Cellular Immunotherapy, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
Michael R Clausen - Department of Medicine, Vejle Hospital, Vejle, Denmark
Björn E Wahlin - Institution for Medicine at Huddinge, Karolinska Institutet and Medical Unit Hematology at Solna, Cancer, Karolinska University Hospital, Stockholm, Sweden
Jonathan W Friedberg - Wilmot Cancer Institute, University of Rochester, Rochester, NY
Carla Casulo - University of Rochester
Thomas M Habermann - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
Yucai Wang - Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
Loretta J Nastoupil - Sisters of Mercy Health System
Peter de Nully Brown - Rigshospitalet, Department of Hematology, Copenhagen, Denmark
David Belada - 4th Department of Internal Medicine-Haematology, University Hospital and Faculty of Medicine, Hradec Kralove, Czech Republic
Andrea Janíková - Faculty of Medicine, Masaryk University, Brno, Czech Republic
Heidi Mocikova - Fakultni nemocnice Kralovske Vinohrady, Department of Haematology and Third Faculty of Medicine, Charles University, Prague, Czech Republic
Tomáš Fürst - Faculty of Science, Palacky University Olomouc, Olomouc, Czech Republic
Pierre Feugier
Hervé Tilly - Department of Hematology and U1245, Centre Henri Becquerel, Rouen, France
Corinne Haioun - Lymphoid Malignancies Unit, Assistante Publique Hôpitaux de Paris APHP, Hopital Henri Mondor, Creteil, France
Andrew J Davies - Cancer Sciences Division, Somers Cancer Research Building, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
Guillaume Cartron - Hematology Department, University Hospital, UMR-CNRS553, Montpellier, France
Richard Burack - University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, Rochester, NY
Dai Chihara - Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX
Peter Martin - Division of Hematology/Oncology, Weill Cornell Medicine, New York, NY
Jonathon B Cohen - Department of Hematology and Medical Oncology, Emory University School of Medicine-Winship Cancer Institute, Atlanta, GA
Izidore S Lossos - Lymphoma Section, University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
Brad S Kahl - Washington University School of Medicine, St Louis, MO
Laurie H Sehn - University of British Columbia
Karin E Smedby - Karolinska University Hospital
Gilles Salles - Weill Cornell Medical College, New York, NY
Marek Trneny - Charles University
Brian K Link - Division of Hematology, Oncology, and Bone and Marrow Transplantation, Department of Internal Medicine, University of Iowa, Iowa City, IA
Franck Morschhauser - Department of Hematology, Centre Hospitalier Universitaire de Lille, Groupe de Recherche sur les Formes Injectables et les Technologies Associées, Lille, France
James R Cerhan - Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
Détails de publication: Journal of clinical oncology, p.JCO2500892
Note de subvention: UH2 CA292129 / NCI NIH HHS U01 CA195568 / NCI NIH HHS P50 CA097274 / NCI NIH HHS
Identifiants: 99139754209311
Unité académique: Institut de Génétique Moléculaire de Montpellier - IGMM
Langue: English
Type de ressource: Journal article