Circulating tumor DNA MRD assessment in LBCL

Results from an integrated analysis of five prospective studies (NCT04002947, NCT00398177, NCT02529852, NCT04231877, and NCT04134936) evaluating the prognostic utility of ultrasensitive circulating tumor DNA (ctDNA) as measurable residual disease (MRD) in 137 patients with large B-cell lymphoma (LBCL) receiving first-line anthracycline-based chemotherapy were recently published in the Journal of Clinical Oncology by Roschewski et al.

Key data: Detectable ctDNA after 2 cycles was associated with worse 2-year progression-free survival (PFS; 67% vs 96%; hazard ratio [HR], 6.9; p = 0.0025) compared with undetectable ctDNA. At the end of therapy, detectable ctDNA was associated with 2-year PFS of 29% vs 97% for undetectable ctDNA (HR, 28.7; p < 0.001). End of therapy ctDNA MRD status demonstrated superior prognostic utility compared with positron emission tomography (PET) scans (HR, 28.3 vs 3.6).

Key learning: Ultrasensitive ctDNA detection after first-line anthracycline-based chemotherapy was more prognostic than conventional PET-based response criteria in patients with LBCL. End of treatment ctDNA MRD status strongly predicts outcomes and may represent a potential refined definition of remission following first-line therapy.