Circulating Tumor DNA Integrated with Interim [18F]FDG PET Is Highly Effective in Predicting Outcome of Relapsed/Refractory Classical Hodgkin Lymphoma Treated with the Begev Regimen

Background.Risk stratification is particularly important to tailor the therapeutic strategy and avoid unnecessary toxicity for the treatment of relapsed/refractory (r/r) classical Hodgkin lymphoma (cHL). Early assessment of chemo-sensitivity by fluoro-deoxy-glucose ([18F]FDG) positron emission tomography (PET) scan is the strongest predictor of outcome in first line setting; however, data are limited in r/r cHL. Circulating tumor DNA (ctDNA) profiling is emerging as a powerful tool for outcome prediction and response monitoring.The BEGEV (BEndamustine, GEmcitabine,Vinorelbine) regimen is routinely offered as salvage strategy prior to autologous (auto) or allogeneic (allo) stem cell transplantation (SCT) in r/r cHL (Santoro, 2016). Early identification of patients who fail this program may have a significant clinical impact in the selection of the optimal therapeutic strategy for r/r cHL.