Is ctDNA the Secret to Noninvasive Detection & Treatment of Lymphoma?

Nearly 5% of all cancer diagnoses in the U.S. are lymphoma. This cancer of the lymphatic system represents close to a third of all hematological disorders. The National Cancer Institute estimates close to 800,000 Americans are living with lymphoma. While there are about 90 subtypes, non-Hodgkin’s lymphoma is the most prominent.

Like in many other diseases, early detection is critical, especially when symptoms can indicate a range of possible conditions. The most common lymphoma symptom is adenopathy (swollen or enlarged lymph nodes), which can come and go for years. As the disease progresses, people experience other symptoms, such as fever, unexplained weight loss, and night sweats.

A significant biomarker

Circulating tumor DNA (ctDNA) is a lymphoma biomarker that can be detected at measurable levels even in the early stages of the disease. Both PCR and NGS methods can be used. For example, in the article Molecular features encoded in the ctDNA reveal heterogeneity and predict outcome in high-risk aggressive B-cell lymphoma, the authors state, “ctDNA captures the complete lymphoma ecosystem that extends beyond tumor biopsies, imaging, and clinical estimates.”

Genotypic profiles in ctDNA correlate with those in tissue, while ctDNA can reveal mutations that tissue biopsy does not, offering physicians and patients a proven noninvasive testing option. Recent research highlighted that the role of ctDNA in managing treatment and detecting relapses in aggressive forms of the disease since its levels change quickly after therapy begins.

The above mentioned study found genomic patterns in ctDNA that can identify patients who are likely to relapse or not respond to standard treatment. This led the researchers to suggest pretreatment ctDNA analysis can be used in clinical trial design and to create personalized treatment, resulting in improved outcomes.

A new standard 

LGC Clinical Diagnostics has developed the first comprehensive set of lymphoid cancer DNA reference materials designed to help clinical labs better develop, characterize, and validate assays designed to assess lymphoid diseases in different sample types now including ctDNA:

These materials are unique, high-quality products, including SNVs, INDELs, and gene fusions that are important for the disease diagnosis and prognosis. They’re available as purified genomic DNA, ctDNA, and FFPE curls for end-to-end assay performance monitoring.

Clinical labs can confidently develop and validate lymphoid NGS-based assays using these highly multiplexed reference materials containing lymphoma biomarkers. These products support robust sensitivity of detecting clinically relevant mutations at variant allele frequencies that help establish and validate assay LoD claims. Mutation targets are quantitated using highly sensitive digital PCR and a custom NGS assay.

We offer a comprehensive portfolio of reference materials for oncology, designed and manufactured with precision that meets the demands of NGS assays. In addition to ctDNA, it includes NGS platform agnostic ground-truth RNA and genomic DNA-based materials.

To learn more, click here or on the button below.

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  • Circulating Tumor DNA in Lymphoma: Principles and Future Directions, Mark Roschewski, Davide Rossi, David M. Kurtz, Ash A. Alizadeh, and Wyndham H. Wilson
  • Lymphoma: Diagnosis and Treatment, William D. Lewis, MD; Seth Lilly, PharmD, BCPS; and Kristin L. Jones, PA-C West Virginia University Eastern Division, Harpers Ferry, West Virginia 
  • Lymphoid Neoplasia: Molecular features encoded in the ctDNA reveal heterogeneity and predict outcome in high-risk aggressive B-cell lymphoma, Leo Meriranta, Amjad Alkodsi, Annika Pasanen, Maija Lepisto, Parisa Mapar, Yngvild Nuvin Blaker, Judit Jørgensen, Marja-Liisa Karjalainen-Lindsberg, Idun Fiskvik, Lars Tore G. Mikalsen, Matias Autio, Magnus Bjorkholm, Mats Jerkeman, Øystein Fluge, Peter Brown, Sirkku Jyrkkio, Harald Holte, Esa Pitkanen, Pekka Ellonen, and Sirpa Leppa 
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