THE LUGANO CLASSIFICATION

THE LUGANO CLASSIFICATIONRECOMMENDATIONS FOR HODGKIN S AND NON-HODGKIN SLYMPHOMA: STAGING, RESPONSE ASSESSMENT AND FOLLOW UPEmanuele Zucca, MDFrancesca Pavanello, MDOncology Institute of Southern Switzerland (IOSI)RECOMMENDATIONS:INITIAL EVALUATIONBACKGROUND2011 workshop at 11-ICML 2007 IWG revised guidelines1999 NCI criteria2014 LUGANO Classification1971 Ann Arbor Classification1988 Cotswolds modification2013 2ndworkshop at 12-ICMLB arrington SF, et 2014;32(27):3048-58 -Cheson BD, et al. JCO 2014;32(27):3059-68 SF BarringtonNG MikhaeelL KostakogluM MeignanM HutchingsS M ellerLH SchwartzE ZuccaRI FisherJ TrotmanOS HoekstraRJ HicksMJ O DohertyR HustinxA BiggiBD ChesonBD ChesonRI FisherSF BarringtonF CavalliLH SchwartzE ZuccaTA Lister11-ICML & 12-ICML WORKSHOPS Recommendations for initial evaluation, and response assessment of HL and NHL To update 2007 IHP criteria For use in clinical practice and late phase trials Two consensus paper in JCO 2014 OVERARCHING GOALS OFTHE REVISION: LUGANO CLASSIFICATION 2014 Universally applicable Improve lymphoma patient evaluation Eliminate ambiguity Facilitate the comparison of patients and results amongst studies Simplify the evaluation of new therapi

(DEAUVILLE CRITERIA) 1. i.e., maximum standardized uptake value (SUVmax) of the lesion >2x liver uptake Score 18-FDG uptake 1 No uptake 2 ≤ Mediastinal blood pool 3 > Mediastinum and ≤ liver 4 Moderately > liver at any site 5 Markedly1 > liver at any site and/or new sites of disease X New areas of uptake unlikely to be related to lymphoma

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