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- Title
Clinical implications of circulating tumor DNA in predicting the outcome of diffuse large B cell lymphoma patients receiving first-line therapy.
- Authors
Li, Miaomiao; Mi, Lan; Wang, Chunyang; Wang, Xiaojuan; Zhu, Jianhua; Qi, Fei; Yu, Hui; Ye, Yingying; Wang, Dedao; Cao, Jiaowu; Hu, Dingyao; Yang, Quanyu; Zhao, Dandan; Ma, Tonghui; Song, Yuqin; Zhu, Jun
- Abstract
<bold>Background: </bold>Circulating tumor DNA (ctDNA) has been proven to be a promising tumor-specific biomarker in solid tumors, but its clinical utility in risk stratification and early prediction of relapse for diffuse large B cell lymphoma (DLBCL) has not been well explored.<bold>Methods: </bold>Here, using a lymphoma-specific sequencing panel, we assessed the prognostic and predictive utilities of ctDNA measurements before, during, and after first-line therapy in 73 Chinese DLBCL patients.<bold>Results: </bold>The pretreatment ctDNA level serving as an independent prognostic factor for both progression-free survival (PFS, adjusted HR 2.47; p = 0.004) and overall survival (OS, adjusted HR 2.49; p = 0.011) was confirmed in our cohort. Furthermore, the patients classified as molecular responders who presented a larger decrease in ctDNA levels after the initial two treatment cycles had more favorable PFS (unreached vs. 6.25 months; HR 5.348; p = 0.0015) and OS (unreached vs. 25.87; HR 4.0; p = 0.028) than non-responders. In addition, interim ctDNA clearance may be an alternative noninvasive method of positron emission tomography and computed tomography (PET-CT) for predicting better PFS (HR 3.65; p = 0.0033) and OS (HR 3.536; p = 0.016). We also demonstrated that posttreatment ctDNA was a sensitive indicator for detecting minimal residual disease (MRD) in patients with a high risk of recurrence (HR 6.471; p = 0.014), who were otherwise claimed to achieve radiographic CR (complete remission).<bold>Conclusions: </bold>CtDNA is a promising noninvasive tool for prognosis prediction, response assessment, and early relapse prediction of first-line treatment in DLBCL patients.
- Publication
BMC Medicine, 2022, Vol 20, Issue 1, p1
- ISSN
1741-7015
- Publication type
journal article
- DOI
10.1186/s12916-022-02562-3