Circulating tumor DNA in B cell lymphomas.

Area of Science:

• Oncology
• Genetics
• Molecular Diagnostics

Background:

• Standard lymphoma management relies on invasive biopsies and imaging, which have limitations in providing real-time disease status.
• Circulating tumor DNA (ctDNA) analysis presents a promising minimally invasive approach for monitoring lymphoma.
• Understanding ctDNA's role is crucial for advancing personalized cancer care.

Purpose of the Study:

• To review the significance of circulating tumor DNA (ctDNA) in managing various lymphoma subtypes.
• To highlight ctDNA's potential to overcome limitations of conventional diagnostic methods.
• To assess ctDNA's utility in real-time monitoring and personalized treatment strategies for lymphoma patients.

Main Methods:

• Literature review of studies evaluating ctDNA in lymphoma.
• Analysis of ctDNA's performance in different lymphoma types, including Hodgkin lymphoma, DLBCL, PCNSL, IVLBCL, and indolent lymphomas.
• Assessment of ctDNA's correlation with tumor burden, clonal evolution, and treatment resistance.

Main Results:

• ctDNA analysis provides real-time insights into tumor burden, clonal evolution, and treatment resistance, complementing standard biopsies and imaging.
• In Hodgkin lymphoma, ctDNA facilitates genomic profiling and treatment monitoring.
• ctDNA shows promise in DLBCL for tracking resistance, especially with CAR T-cell therapy, and in rare subtypes for diagnosis and relapse detection.

Conclusions:

• ctDNA analysis is poised to be integral to personalized lymphoma management, enabling timely interventions.
• Standardization of methodologies and large-scale validation trials are essential for routine clinical implementation.
• ctDNA offers potential for improved relapse monitoring and risk assessment in indolent lymphomas.