The relevance of circulating tumor DNA (ctDNA) analysis as a liquid biopsy and minimal residual disease tool in the management of classical Hodgkin Lymphoma (cHL) patients was demonstrated in retrospective settings and remains to be confirmed in a prospective setting.We developed a targeted Next-Generation sequencing (NGS) panel for fast analysis (AmpliSeq technology) of nine commonly mutated genes in biopies and ctDNA of cHL patients.We then conducted a prospective trial to assess ctDNA follow up at diagnosis and Pasta after 2 cycles of chemotherapy (C2).Sixty cHL patients treated by first line conventional chemotherapy (BEACOPPescalated [21.
3%], ABVD/ABVD-like [73.5%] and other regimens [5.2%, for elderly patients] were assessed in this non-interventional study.Median age of the patients was 33.
5 years (range 20-86).Variants were identified in 42 (70%) patients.Mutations of NFKBIE, TNFAIP3, STAT6, PTPN1, B2M, XPO1, ITPKB, GNA13 and SOCS1 were found in 13.3%, 31.
7%, 23.3%, 5%, 33.3%, 10%, 23.3%, 13.
3% and 50% of patients, respectively.ctDNA concentration and genotype are correlated with clinical characteristics and presentation.Regarding early therapeutic response, 45 patients (83%, NA=6) had a negative positron emission tomography (PET) after C2 (Deauville Score 1-3).Mean of DeltaSUVmax after C2 was -78.
8%.We analyzed ctDNA after C2 for 54 patients (90%).ctDNA became rapidly undetectable in all cases after C2.Variant detection in ctDNA is suitable to depict the genetic features of cHL at diagnosis and may help to Grill / Griddle Pads assess early treatment response, in association with PET.
Clinical Trial reference: NCT02815137.