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

Summary

The purpose of this study is to compare the predictive value in terms of specificity of circulating tumor DNA (ctDNA) and positron emission computed tomography (PET-CT) after 2 cycles of chemotherapy (C2), on the probability of obtaining a metabolic complete response after 4 cycles of induction chemotherapy (C4) in patients with primary mediastinal large B cell lymphoma (PMBL) receiving standard R-CHOP14 or R-ACVBP.

Eligibility

Inclusion Criteria:

* Patient over 18 years of age,
* Suffering from a diffuse primary B lymphoma of the mediastinum, newly diagnosed locally on a biopsy with anatomopathological analysis according to the recommendations of the WHO 2016 classification of hematological malignancies,
* All stages (I-IV)
* All IPI scores (0-5)
* With mediastinal involvement,
* Untreated (apart from emergency corticosteroid therapy less than 2mg/kg/day for 7 days),
* Treatment with R-CHOP-14 or R-ACVBP with PET-CT guided strategy (delta SUVmax) to be initiated,
* Tumor fixation above liver background on pre-treatment FDG PET/CT/CT (Deauville score ≥4),
* Having signed the informed consent prior to any study procedure
* Affiliated or beneficiary of a social protection plan.

Exclusion Criteria:

* Patient who has already started chemotherapy treatment,
* Contraindication to FDG PET-CT,
* No mediastinal involvement,
* Positive HIV serology,
* Positive hepatitis B or C serology with positive viral load,
* Protected adult (under guardianship or curatorship),
* Pregnant or breastfeeding women,
* Patient unable to understand the study for any reason or to comply with the constraints of the trial (language, psychological, geographical problems, etc.).

Conditions2

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