AI Article Synopsis
- A novel ctDNA testing method shows potential for improving prognosis and treatment monitoring in diffuse large B-cell lymphoma (DLBCL) patients.
- In a study of 50 DLBCL patients, ctDNA was detected in 95% pre-treatment, and higher baseline levels were linked to poorer outcomes, while clearance during treatment predicted better responses.
- Overall, ctDNA clearance was a strong predictor of favorable patient outcomes and could lead to earlier detection of treatment responses compared to traditional imaging methods.
Article Abstract
Background: A novel approach for molecular residual disease (MRD) detection and treatment monitoring is needed in diffuse large B-cell lymphoma (DLBCL) to identify patients with a poor prognosis. We performed a retrospective evaluation of commercial ctDNA testing in patients with stage I-IV DLBCL to evaluate the prognostic and predictive role of tumor-informed ctDNA assessment.
Methods: A personalized and tumor-informed multiplex PCR assay (Signatera™ bespoke mPCR NGS assay) was used for ctDNA detection and quantification.
Results: In total, 50 patients (median age: 59 years; median follow-up: 12.68 months) were analyzed, of which 41 had pretreatment time points with ctDNA detected in 95% (39/41). Baseline ctDNA levels correlated with R-IPI scores and stage. ctDNA clearance during first-line therapy was predictive of improved therapy responses and outcomes (EFS, HR: 6.5, 95% CI: 1.9-22, p=0.003 and OS, HR: 22, 95% CI: 2.5-191, p=0.005). Furthermore, 48% (13/27) of patients cleared their ctDNA following the first cycle of treatment. Patients who cleared their ctDNA, irrespective of their R-IPI score, had superior outcomes compared to ctDNA-positive patients. ctDNA clearance outperformed other factors associated with EFS in multivariate analysis (HR: 49.76, 95% CI:1.1-2225.6, p=0.044). Finally, ctDNA clearance predicted complete response (CR)/no evidence of disease (NED) on average 97 days (range: 0-14.7 months) ahead of imaging/biopsy.
Conclusion: ctDNA testing in patients with DLBCL is predictive of patient outcomes and may enable personalized surveillance, intervention, and/or trial options.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317400 | PMC |
| http://dx.doi.org/10.3389/fonc.2024.1407003 | DOI Listing |
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