ICML 2025 | Exploring the use of ctDNA for monitoring MRD in patients with PMBCL

We performed recently a study and we presented this year at ICML the result of the CAMIL study. It’s a multicenter prospective trial dedicated to monitoring ctDNA, so minimal residual disease using circulating tumor DNA in patients with newly diagnosed primary mediastinal lymphoma. This trial was conducted in 30 LYSA centers in France and we enrolled approximately 84 patients with a median age of 37 years old. And we observed that ctDNA was detectable at baseline in 98% of patients. And also we observed that patients with a negative ctDNA after four cycles of chemotherapy display a very good prognosis with a one-year progression-free survival of 98% as compared to a patient with a positive ctDNA after four cycles which was 33%. So there was a strong discrepancy between patients with a negative ctDNA and positive ctDNA. We also observed that patients with a positive PET scan, 80% of them have a negative ctDNA and finally they did well. In the same time we observed that 60% of the patients with a progression of the disease after four cycles of chemotherapy had a negative PET scan but a positive ctDNA. So taking together these two markers, so dual negativity, PET scan negative and ctDNA negative, we may identify a subgroup of patients with very good outcome with no patient having a relapse when they have both negative markers. So to summarize our findings, ctDNA levels kinetics are a robust and complementary marker to PET scan and we believe that integrating these two markers together in next clinical trials as a primary endpoint may help us to refine risk stratification in primary mediastinal lymphoma and also to guide treatment decision in this young patient population exposed to long-term toxicity.

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