“In 2015, papers showed that ctDNA could suggest relapse noninvasively in serial plasma samples. In those studies, ctDNA was positive prior to relapse detected by computed tomography scans,” explained session moderator David Scott, MBChB, PhD, of the Center for Lymphoid Cancer, BC Cancer, Vancouver.

David Scott, MBChB, PhD

“Since then, panel sequencing and beyond has led to an expanded role for ctDNA. This technique has potential for diagnosing lymphomas, … assessing prognosis and early response to treatment, early detection of disease relapse, as well as tracing tumor evolution and identifying mutations that underlie treatment resistance,” Dr. Scott stated.

Questions to Resolve

Dr. Scott mentioned a number of questions to be resolved before ctDNA is used routinely in the clinic. Can ctDNA be used to assess mutational status to put people on clinical trials? Should broad panels be used for hematologic malignancies or specific panels for each malignancy? How can standardization be implemented for what is sequenced and how it is done? How can ctDNA inform clinical practice?

“ctDNA is an exciting topic,” said Dr. Scott. “We are on the verge of seeing exciting pushes [for this technology] into various areas of clinical management.” 

DISCLOSURE: Dr. Scott has served as a consultant or advisor to AbbVie, AstraZeneca, Celgene, and Janssen; has received research funding from Janssen, NanoString Technologies, and Roche/Genentech; and holds intellectual property
on several pending patents on gene-expression profiling for lymphomas.