ctDNA negative status contributes to positive outcomes for DLBCL
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CHICAGO — Negative circulating tumor DNA status contributed to a PFS benefit for patients with previously untreated diffuse large B-cell lymphoma, according to research presented at ASCO Annual Meeting.
The study, presented by Alex Herrera, MD, evaluated 654 patients who had circulating tumor DNA (ctDNA) status. Of the total number of patients, 57% treated with Pola-R-CHP (polatuzumab vetodin, rituximab, cyclophosphamide, doxorubicin and prednisone) achieved undetectable ctDNA and 59% treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) achieved the same. In all analyses, patients who achieved negative ctDNA showed better 3-year PFS and OS, regardless of treatment.
“Achieving ctDNA negativity by cycle five, day 1, and end of treatment was prognostic of prolonged PFS and OS,” Herrera, chief of the division of lymphoma, department of hematology and hematopoietic cell transplantation at City of Hope, said.
Herrera noted longer PFS in patients with ctDNA treated with Pola-R-CHP vs. R-CHOP both at cycle five, day 1 (HR = 0.71; 95% CI; 0.41-1.21) and end of treatment (HR = 0.56; 95% CI: 0.32-0.98). Using PET-CT imaging to determine complete response showed superior survival for patients with ctDNA negativity and PET-CT complete response and improved PFS with Pola-R-CHP vs. R-CHOP.
“Interestingly, patients who had detectable ctDNA at end of treatment, who had a negative PET scan, had similar outcomes,” Herrera said.
This suggests that there were “deeper molecular responses” in the Pola-R-CHP arm, Herrera said.
“Combining ctDNA assessment and PET CT imaging can further enhance risk stratification, and particularly in patients treated with Pola-R-CHP,” Herrera said.
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Herrera, A, et al. Abstract 7523. Presented at: American Society of Clinical Oncology Meeting; June 2-6, 2023; Chicago.
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