627. Aggressive Lymphoma (Diffuse Large B-Cell and Other Aggressive B-Cell Non-Hodgkin Lymphomas)—Results from Retrospective/Observational Studies: Prognostic Markers

Conclusion cited from the abstract: I-PET is able to significantly discriminate between responding and non-responding patients after 2, 3 or 4 cycles of chemotherapy. The optimal timing to identify responders is after 2 cycles, as there is no significant increase in survival at later times, regardless of PET criteria. As the PFS of I-PET4 positive patients is significantly lower than that of I-PET2 patients, I-PET4 might be the optimal timing to identify non-responders. We suggest to perform an I-PET4 scan to identify poor-responding patients. The worst prognostic subgroup is best identified using the DS 5 positive or ΔSUV criteria. Based on these data, I-PET could be used to design response adapted trials for patients with good and poor responses respectively.

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Conclusion cited from the abstract: 

High MH predicts worse prognosis in the patients with newly diagnosed DLBCL independently of NCCN-IPI and was not correlated with TMTV. Baseline MH is a novel prognostic biomarker in DLBCL.

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Conclusion cited from the abstract: EoT CR status according to RECIL 2017 criteria showed a high concordance with CMR status by Lugano 2014 criteria and was highly prognostic for PFS and OS in previously untreated DLBCL; however, discordance was seen for the identification of PD by RECIL compared with Lugano criteria. PFS as assessed by CT by RECIL, based on uni-dimensional size measurements of up to three target lesions, showed high concordance with PFS by Lugano criteria, based on bi-dimensional size measurements of up to six target lesions.

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Conclusion cited from the abstract: We describe a single NGS-based method, which calls variants, determines COO, and assesses tumor burden from plasma. Using these results, we show that pre-treatment plasma-based molecular and tumor burden measurements in previously untreated DLBCL pts correlate with PFS.

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Conclusion cited from the abstract: Shorter DTI is associated with higher pretreatment ctDNA levels in patients with aggressive B-cell lymphomas. When comparing to established factors (DTI, IPI, MTV), pretreatment ctDNA levels appear to best predict clinical outcomes. This suggests that quantification of ctDNA better reflects disease burden and treatment urgency than existing clinical biomarkers. Pretreatment ctDNA level may therefore be a valuable metric for disease aggressiveness of patients included in clinical trials, and may help identify studies suffering from selection bias. This may be particularly useful for noncontrolled Phase I/II single arm trials, but also for stratification in randomized trials.

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Conclusion cited from the abstract: Isolation of cfDNA was feasible in >95% of lymphoma patients independently of histology or disease stage. Patients with DLBCL exhibited the higher cfDNA concentration which were also correlated with LDH concentrations and high-risk IPI. Kinetics of [cfDNA] is related to response to therapy in DLBCL and also might detect relapse. Even though additional studies are necessary, monitoring of cfDNA may help in management of patients with DLBCL.

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