Large B-cell lymphoma affecting the central nervous system
Large B-cell lymphoma affecting the central nervous system remains challenging to treat. Patients are often significantly affected by motor, sensorial, and/or cognitive impairment and at high risk for severe toxicities following immunochemotherapy. Current risk scores rely on clinical features and lack sensitivity to define a patient’s individual risk for relapse. We have recently shown that plasma-derived circulating tumor (ct)DNA is a promising biomarker that has the potential to overcome these limitations. Plasma-derived ctDNA allows for noninvasive assessment of response to therapy and is predictive of outcomes in patients with CNS lymphoma. However, the role of the blood-brain-barrier and its implications on ctDNA levels and dynamics in the peripheral blood remain elusive. By applying ultrasensitive high-throughput-sequencing to tumor samples and ctDNA derived from cerebrospinal fluid and peripheral blood in patients with CNS lymphoma, we aim at elucidating the role of the blood-brain-barrier in the context of CNS lymphoma and different treatment strategies. Finally, we aim at evaluating how plasma-derived ctDNA sequencing might help to individually guide treatment in patients with CNS lymphoma.