Personalized monitoring of circulating tumor DNA with a specific signature of trackable mutations after chimeric antigen receptor T-cell therapy in follicular lymphoma patients

FRONTIERS IN IMMUNOLOGY — 2023 

Jiménez-Ubieto A., et al.

This proof-of-principle study explored personalized ctDNA monitoring after CAR-T therapy in follicular lymphoma, showing potential value for response assessment and post-treatment surveillance. 

Topics

Hematologic malignancies · Follicular lymphoma · CAR-T · MRD · Therapy monitoring · DUALseq · TRACKseq

Expanded summary

This study evaluated personalized ctDNA monitoring in follicular lymphoma patients treated with anti-CD19 CAR-T therapy. Genomic profiling before lymphodepletion was used to identify patient-specific somatic mutations, which were then tracked in serial cfDNA samples after treatment.

After a median follow-up of 36 months, all patients achieved complete response as best response, while two patients progressed. The study found that durably responding patients had undetectable ctDNA around three months after infusion, and all progressing patients were liquid biopsy MRD-positive before progression.

For Altum, this paper supports the value of longitudinal ctDNA tracking in advanced therapy settings, particularly where molecular monitoring may help interpret response dynamics alongside PET/CT. It also provides a scientific bridge toward disease and therapy monitoring approaches relevant to DUALseq.

View article: https://doi.org/10.3389/fimmu.2023.1188818