Study of Circulating Tumor DNA and PET-CT to Predict Treatment Response in Primary Mediastinal Large B-cell Lymphoma Comparing Predictive Value After 2 and 4 Cycles of Chemotherapy with R-CHOP-14 or R-ACVBP

What this Trial Is About

Researchers are evaluating the predictive value of circulating tumor DNA ctDNA compared to positron emission computed tomography PET-CT in patients with primary mediastinal large B cell lymphoma PMBL undergoing chemotherapy. The study aims to determine which method better predicts a complete metabolic response after 4 cycles of induction chemotherapy. This is a prospective, multicenter study designed to improve early identification of chemo refractory patients and personalize treatment plans using biomarkers like ctDNA detected by Next-Generation Sequencing NGS. Participants will receive standard chemotherapy treatment with either R-CHOP14 or R-ACVBP following a PET-CT guided strategy. ctDNA levels will be monitored after 2 and 4 cycles of chemotherapy to assess molecular response. The study classifies patients by their ctDNA status at diagnosis and after treatment cycles, comparing these groups to evaluate the value of ctDNA as a biomarker alongside PET-CT imaging. During the study, participants will undergo PET-CT scans and blood tests to measure ctDNA at specific treatment milestones. Researchers will analyze molecular and metabolic responses, overall survival, and progression-free survival over several years. The study includes assessments such as genomic sequencing, gene expression profiling, and correlation of tumor and circulating DNA. Participation involves signing informed consent and completing treatment and follow-up evaluations scheduled by the research team.

Circulating Tumor DNA in Primary Mediastinal Large B-cell Lymphoma (PMBL)