Interest of Individual Biomarkers From the Identification of Tumor Genotype by High-throughput Molecular Techniques
Interest of Individual Biomarkers From the Identification of Tumor Genotype by High-throughput Molecular Techniques
Lymphomas are the most common haemopathic malignancy. The 3 most common types are diffuse
 large B-cell lymphoma (DLBCL), Hodgkin's lymphoma (HL) and follicular lymphoma (FL). In these
 three subtypes, the treatment strategy is most often curative. The therapeutic strategy is
 guided by PET (positron emission tomography), which optimises the risk-benefit balance
 between the efficacy and toxicity of the treatment and makes it possible to limit the
 intensity of treatment for good responders and to intensify the treatment of poor responders
 with a worse prognosis. PET therefore plays a central role in the pre-therapeutic evaluation
 of the disease and in the assessment of response to treatment. However, other complementary
 approaches could improve characterization prior to initiating lymphoma t-treatment and
 individual patient management during treatment and beyond. In DLBCL, it has been shown that
 the risk of relapse of good and bad responders is decreased by combining the PET response
 with a reduction in the amount of tumor DNA (ctDNA) in the blood, i.e. the genetic program of
 lymphoma cells that circulates freely in the blood. This evaluation of ctDNA has been made
 possible by the development of innovative techniques such as Next Generation Sequencing
 (NGS). In lymphomas, several approaches have been developed, the most sensitive and promising
 being CAPP-Seq (CAncer Personalized Profiling by deep Sequencing) developed at Stanford
 University.

 It is therefore useful to study the description of ctDNA in the 3 types of lymphomas and to
 analyse the progression profiles under treatment by trying to establish the major potential
 usefulness of these techniques: modifying treatment in case of poor response based on ctDNA
 +/- and PET, detecting relapses earlier than at present in patients without any other sign of
 relapse (clinical, blood or PET).

 The project presented here aims to build a collection of plasma samples taken before
 treatment, during treatment and during the first 2 years of follow-up in patients with one of
 the 3 most frequent types of lymphoma and undergoing curative treatment. The hypothesis is
 that sequential evaluation of ctDNA could improve the individualized management of future
 patients based on the results generated by the analyses of patients in this cohort.
Inclusion Criteria:

 -  Person who has not opposed to their inclusion in the trial

 -  Confirmation of the diagnosis of one of the three lymphomas (DGLBL, LF or classic LH)
 according to the WHO 2016 international classification (Smerdlow et al, 2016)

 -  Patients not currently taking treatment for their haemopathy (or who have received
 corticosteroid therapy alone within 14 days prior to the 1st sampling, dose limited to
 500mg total)

 -  Patients requiring systemic treatment within 30 days of screening

 -  PET images available for pre-therapy and follow-up (mid-treatment, end of treatment)

 Exclusion Criteria:

 -  Person subject to legal protection (curatorship, guardianship)

 -  Person under partial judicial control

 -  Pregnant, parturient or breastfeeding woman

 -  Adult incapable or incapable of giving consent

 -  Minor

 -  Localized lymphoma treated by surgery and/or localized radiotherapy