Creating a blood test to predict recurrence of a common lymphoma

2015

Challenge

Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma. Though usually curable, when treatment fails, the long-term prognosis is poor. Relapses of DLBCL often occur because current imaging technology cannot detect residual disease. Researchers set out to find a more precise way to monitor the disease.

Advance

IRP investigators led by Wyndham Wilson, M.D., Ph.D., analyzed serum from 126 patients with DLBCL for the presence of circulating tumor DNA (ctDNA) for years after the patients had completed therapy. By quantifying the levels of tumor DNA pre- and post-treatment, Wilson’s team found that the patients who had detectable levels of ctDNA during surveillance were more than 200 times more likely to experience disease progression.

Impact

Measuring levels of ctDNA enables the detection of DLBCL recurrence earlier than clinical evidence of the disease can be detected. The test also predicts which patients will respond to therapy as early as the second cycle of treatment, a strategy known as interim monitoring, providing doctors and patients with more lead-time to treat the disease.

Publications

Roschewski M, Dunleavy K, Pittaluga S, Moorhead M, Pepin F, Kong K, Shovlin M, Jaffe ES, Staudt LM, Lai C, Steinberg SM, Chen CC, Zheng J, Willis TD, Faham M, Wilson WH. (2015) Circulating tumour DNA and CT monitoring in patients with untreated diffuse large B-cell lymphoma: a correlative biomarker study. Lancet Oncology. 16(5), 541-9