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- Title
Liquid biopsy for molecular characterization of diffuse large B‐cell lymphoma and early assessment of minimal residual disease.
- Authors
Alcoceba, Miguel; Stewart, James P.; García‐Álvarez, María; Díaz, Luis G.; Jiménez, Cristina; Medina, Alejandro; Chillón, M. Carmen; Gazdova, Jana; Blanco, Oscar; Díaz, Francisco J.; Peñarrubia, María J.; Fernández, Silvia; Montes, Carlos; Cabero, Almudena; Caballero, María D.; García‐Sanz, Ramón; González, Marcos; González, David; Tamayo, Pilar; Gutiérrez, Norma C.
- Abstract
Summary: Circulating tumour DNA (ctDNA) allows genotyping and minimal residual disease (MRD) detection in lymphomas. Using a next‐generation sequencing (NGS) approach (EuroClonality‐NDC), we evaluated the clinical and prognostic value of ctDNA in a series of R‐CHOP‐treated diffuse large B‐cell lymphoma (DLBCL) patients at baseline (n = 68) and after two cycles (n = 59), monitored by metabolic imaging (positron emission tomography combined with computed tomography [PET/CT]). A molecular marker was identified in 61/68 (90%) ctDNA samples at diagnosis. Pretreatment high ctDNA levels significantly correlated with elevated lactate dehydrogenase, advanced stage, high‐risk International Prognostic Index and a trend to shorter 2‐year progression‐free survival (PFS). Valuable NGS data after two cycles of treatment were obtained in 44 cases, and 38 achieved major molecular response (MMR; 2.5‐log drop in ctDNA). PFS curves displayed statistically significant differences among those achieving MMR versus those not achieving MMR (2‐year PFS of 76% vs. 0%, p < 0.001). Similarly, more than 66% reduction in ΔSUVmax by PET/CT identified two subgroups with different prognosis (2‐year PFS of 83% vs. 38%; p < 0.001). Combining both approaches MMR and ΔSUVmax reduction, a better stratification was observed (2‐year PFS of 84% vs. 17% vs. 0%, p < 0.001). EuroClonality‐NDC panel allows the detection of a molecular marker in the ctDNA in 90% of DLBCL. ctDNA reduction at two cycles and its combination with interim PET results improve patient prognosis stratification.
- Subjects
DIFFUSE large B-cell lymphomas; POSITRON emission tomography computed tomography
- Publication
British Journal of Haematology, 2024, Vol 205, Issue 1, p109
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.19458