DLBCLCLIA-validated in peripheral blood and bone marrow
Detect clinical relapse earlier in DLBCL with clonoSEQ
Imaging is standard. But challenges remain.
The qualitative nature of PET and/or CT scans can lead to:
- Difficulties in understanding the true magnitude of changes in disease burden2-4
- False positives due to inferior specificity5
Only complete disease eradication can “cure” DLBCL. Detecting residual disease at the lowest possible level is paramount.6-7
Throughout first-line
treatment and surveillance,
clonoSEQ can clarify
imaging results
Use clonoSEQ to complement PET
and/or
CT imaging when results
are inconclusive
Imaging can be inconclusive due to poor visualization, acquisition parameter errors, patient movement, and more6
~20%
Patients who achieve CR (as defined by imaging) with first-line therapy will eventually relapse*6,8
3.5months
Median amount of time clonoSEQ detected residual disease before clinical relapse, in one study*7
In post–first-line surveillance, clonoSEQ is the quantitative
assessment your patients need
For patients in remission, MRD monitoring provides early detection of recurring disease, which may enable earlier interventions or adjustments of management strategies.
Surveillance circulating tumour DNA identified risk of recurrence before clinical evidence of disease in most patients, with a higher sensitivity than CT imaging, and resulted in a reduced disease burden at relapse.
-Roschewski7
A prospective study found that measuring MRD by clonoSEQ after CAR T-cell therapy sensitively predicted impending relapse
clonoSEQ accurately predicted whether progression would occur in 85% of patients (23/27)‡9
At day 28 after CAR-T therapy, peripheral blood MRD assessments can be predictive of progression events providing added value to standard PET/CT scans.9
CAR, chimeric antigen receptor; CR, complete response; CT, computerized tomography; ctDNA, circulating tumor DNA; NPV, negative predictive value; PET, positive emission tomography; PFS, progression-free survival; PPV, positive predictive value.
*Out of 107 DLBCL patients who achieved complete remission after first-line therapy.
†This retrospective study measured ctDNA in DLBCL patients who received EPOCH, with or without rituximab. Patients received ctDNA analysis and concurrent CT scans during most treatment cycles and for up to 5 years following treatment. 36 patients had clinical progression following first-line treatment.
‡This study assessed the prognostic value of ctDNA before and after axicabtagene ciloleucel infusion. ctDNA was available for analysis in 60 patients frequently following lyphodepleting chemotherapy either until progression or 1-year following infusion. RD levels were determined in the 30 patients who progressed and 30 who responded.
About the studies
First-line
A review article highlighting key research of ctDNA in lymphomas, including DLBCL.6
Surveillance
This retrospective study measured ctDNA in DLBCL patients who received EPOCH, with or without rituximab. Patients received ctDNA analysis and concurrent CT scans during most treatment cycles and for up to 5 years following treatment. 36 patients had clinical progression following first-line treatment.7
Post-CAR T-cell therapy
This study assessed the prognostic value of ctDNA before and after axicabtagene ciloleucel infusion. ctDNA was available for analysis in 60 patients frequently following lyphodepleting chemotherapy either until progression or 1-year following infusion. MRD levels were determined in the 30 patients who progressed and 30 who responded.9
This page is intended for a US-based audience.
clonoSEQ® is available as an FDA-cleared in vitro diagnostic (IVD) test service provided by Adaptive Biotechnologies to detect minimal residual disease (MRD) in bone marrow from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (B-ALL) and blood or bone marrow from patients with chronic lymphocytic leukemia (CLL). CLL Clonality (ID) Tests will also produce an IGHV status result, which is provided as a CLIA-validated laboratory developed test (LDT) but which has not been cleared or approved by the FDA. Additionally, clonoSEQ is available for use in other lymphoid cancers and specimen types as a CLIA-validated LDT. For important information about the FDA-cleared uses of clonoSEQ including test limitations, please visit clonoSEQ.com/technical-summary.
References
- Hu R, et al. Curr Oncol Rep. 2019;21(5):44.
- Suh KJ, et al. Korean J Intern Med. 2019;34(4):894-901.
- Carr R, et al. J Nucl Med. 2014;55(12):1936-1944.
- Mamot C, et al. J Clin Oncol. 2015;33(23):2523-2529.
- Thompson CA, et al. J Clin Oncol. 2014;32(31):3506-3512.
- Roschewski M, et al. Blood Cancer Discov. 2022;3(1):5-15.
- Roschewski M, et al. Lancet Oncol. 2015;16(5):541-549.
- Cohen JB, et al. Blood. 2017;129(5):561-564.
- Frank MJ, et al. J Clin Oncol. 2021;39(27):3034-3043.
- El-Galaly T, et al. Leukemia & Lymphoma. 2011;52(4):597-603.
- Avivi I, et al. Am J Hematol. 2013;88(5):400-405.