Liquid Biopsy Using Circulating Tumor DNA Can Predict Treatment Response in Large B-Cell Lymphoma Interview with:
Dr. David Kurtz, MD/PhD, Instructor and
Dr. Ash Alizadeh MD/PhD, Associate Professor
Division of Oncology, Department of Medicine
Stanford University Medical Center What is the background for this study? What are the main findings? 

Response: This work investigates the utility of circulating tumor DNA – a type of liquid biopsy – in diffuse large B-cell lymphoma, the most common blood cancer in adults.

Liquid biopsies are an emerging technology to track cancers from a simple blood draw. Here, using a cohort of over 200 patients from 6 centers across North America and Europe, we asked if circulating tumor DNA could be used to detect lymphoma in patients, and more importantly, could it be used to identify responders and non-responders. What should readers take away from your report?

 Response: Using a technique called Cancer Personalized Profiling by Deep Sequencing, or CAPP-Seq, we were able to detect circulating tumor DNA in 98% of patients prior to treatment. Furthermore, the detection of circulating tumor DNA was reproducible across all the centers and was prognostic for outcomes. We also tracked circulating tumor DNA levels over time.

Much to our surprise, the levels of circulating tumor DNA as early as 21 days into therapy were prognostic for event-free survival. This is a potentially powerful tool for clinicians to predict which patients might respond to therapies, and which might benefit from a change in treatment. What recommendations do you have for future research as a result of this work? 

Response: This work suggests that by assessing the dynamics of circulating tumor DNA over time, physicians can quickly identify patients who are responding to treatment and those who are not. It opens the door to possible studies trying to select therapy for patients based on this assay, leading to personalized treatment options for patients with lymphoma. Is there anything else you would like to add? 

Response: This is an exciting time for liquid biopsies and circulating tumor DNA. The technology has become robust and reproducible. Novel clinical study designs based on circulating tumor DNA are needed and will pave the way for bringing this type of assay into the clinic for patients.


David M. Kurtz, Florian Scherer, Michael C. Jin, Joanne Soo, Alexander F.M. Craig, Mohammad Shahrokh Esfahani, Jacob J. Chabon, Henning Stehr, Chih Long Liu, Robert Tibshirani, Lauren S. Maeda, Neel K. Gupta, Michael S. Khodadoust, Ranjana H. Advani, Ronald Levy, Aaron M. Newman, Ulrich Dührsen, Andreas Hüttmann, Michel Meignan, René-Olivier Casasnovas, Jason R. Westin, Mark Roschewski, Wyndham H. Wilson, Gianluca Gaidano, Davide Rossi, Maximilian Diehn, Ash A. Alizadeh. Circulating Tumor DNA Measurements As Early Outcome Predictors in Diffuse Large B-Cell Lymphoma. Journal of Clinical Oncology, 2018; JCO.2018.78.524 DOI: 10.1200/JCO.2018.78.5246 

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Last Updated on August 23, 2018 by Marie Benz MD FAAD