Personalized treatment of patients with early unfavourable Hodgkin lymphoma using MRD
Positron emission tomography combined with computerized tomography (PET/CT) is the cornerstone procedure for staging and response assessment nowadays and is the most sensitive and specific imaging technique currently available for patients with lymphoma. Mainstay therapy of cHL includes chemotherapy and radiation, with higher stages requiring more aggressive treatment. Since classical HL has excellent cure rates, current trials focus on minimizing long-term toxicities and adverse events from therapy approaches. Despite recent advances and great adaptations in treatment of lymphoma according to its stage, methods for assessing disease stage have remained largely unchanged in several decades. Novel disease assessment techniques are necessary and clinical decision making would benefit from minimally invasive monitoring assays. Next generation sequencing of circulating tumor DNA (ctDNA) have allowed detecting very small amounts of tumor-derived materials shed by the tumor into the bloodstream. Hence minimally invasive, sensitive disease monitoring could be achieved by ctDNA monitoring, which is detectable in the plasma of patients and can be used as a marker for residual disease that correlates with interim PET in other cancers.