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Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma
.
Approximately 20% of patients develop early disease progression (POD24)
within 24 months of diagnosis.
The study aimed to evaluate the significance of
circulating tumor DNA (ctDNA) in predicting response to treatment and POD24 in patients with follicular lymphoma.
The researchers collected a total of 100 plasma samples
from 36 follicular lymphoma patients before and during treatment.
These patients received chemotherapy-rituximab regimen with a median follow-up of 3.
43 years
.
The researchers performed targeted deep sequencing
of cell-free DNA (cfDNA) from plasma samples and tumor tissue DNA from 31 confirmed biopsy samples.
The amount of ctDNA variation in patients with POD24-pos and POD24-neg, non-CR, and CR
Of the variants detected from confirmed biopsy samples, 73% (300/411) were also detected in baseline cfDNA
.
The mean number of variants in baseline cfDNA samples was significantly higher in patients with disease progression (POD24-pos) or complete response (non-CR) within 24 months than in patients with no disease progression (POD24-neg) or complete response (CR) within 24 months (unpaired samples t-test, p-values of 0.
0001 and 0.
001, respectively).
EFS rate in ctDNA-positive or negative patients during follow-up
ctDNA levels before treatment, as haploid genomic equivalents (hGE/mL), were higher in patients who did not achieve a complete response (p=0.
02); Patients with POD24-pos also had higher pre-treatment ctDNA levels (p<0.
001)
compared to patients with POD24-neg.
Dynamic analysis showed a sharp drop in ctDNA levels after treatment, especially in patients who achieved complete remission and POD24-neg
.
In summary, baseline ctDNA levels correlate
with the risk of early progression and response to treatment for follicular lymphoma.
CFDNA monitoring and genotyping during treatment and follow-up can predict early progression and risk of treatment response in
patients with follicular lymphoma.
Original source:
Ismael Fernández-Miranda, Lucia Pedrosa, Marta Llanos, et al.
Monitoring of circulating tumor DNA predicts response to treatment and early progression in follicular lymphoma: results of a prospective pilot study.
Clin Cancer Res 2022; https://doi.
org/10.
1158/1078-0432.
CCR-22-1654
