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01.09.2016 | Lymphoma (JW Sweetenham, Section Editor) | Ausgabe 9/2016

Current Treatment Options in Oncology 9/2016

Circulating Tumor DNA to Monitor Therapy for Aggressive B-Cell Lymphomas

Zeitschrift:
Current Treatment Options in Oncology > Ausgabe 9/2016
Autoren:
MD Mary Kwok, MD S. Peter Wu, MD Clifton Mo, MD Thomas Summers, MD Mark Roschewski
Wichtige Hinweise
This article is part of the Topical Collection on Lymphoma
The views expressed in this [article, speech, presentation, etc.] are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or U.S. Government. Theidentification of specific products or scientific instrumentation does not constitute endorsement or impliedendorsement on the part of the author, DoD, or any component agency. While we generally excisereferences to products, companies, manufacturers, organizations, etc. in government produced works, theabstracts produced and other similarly situated research presents a special circumstance when suchproduct inclusions become an integral part of the scientific endeavor.

Opinion statement

The goal of therapy for aggressive B-cell lymphomas such as diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma (BL) is to achieve cure. Combination chemotherapy with rituximab cures most patients, but those with recurrent disease have a poor prognosis. Medical imaging scans such as computed tomography (CT) and positron emission tomography (PET) are the principal methods to assess response and monitor for disease relapse after therapy but are fundamentally limited by risks of radiation, cost, and a lack of tumor specificity. Novel sequencing-based DNA monitoring methods are capable of quantifying small amounts of circulating tumor DNA (ctDNA) before, during, and after therapy for mature B-cell lymphomas. Detection of ctDNA encoding clonal rearranged variable-diversity-joining (VDJ) receptor gene sequences has demonstrated improved analytical sensitivity and enhanced tumor specificity compared to imaging scans in DLBCL, offering broad clinical applicability across a range of aggressive B-cell lymphomas. Molecular monitoring of ctDNA has vaulted into the spotlight as a promising non-invasive tool with immediate clinical impact on monitoring for recurrence after therapy prior to clinical symptoms. As these clinical observations are validated, ctDNA monitoring needs to be investigated as a tool for response-adapted therapy and as a marker of minimal residual disease upon completion of therapy in aggressive B-cell lymphomas. Molecular monitoring of ctDNA holds tremendous promise that may ultimately transform our ability to monitor disease in aggressive B-cell lymphomas.

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