In the field of lymphoma diagnosis and treatment, traditional methods such as tissue biopsy, while valuable, are increasingly showing limitations due to their invasive nature, inconvenience in repeated sampling, and inability to fully reflect tumor heterogeneity. Liquid biopsy, as an emerging non-invasive testing technology, is demonstrating great potential in the diagnosis and treatment of lymphoma. At the recently held "The 8th Hematologic Oncology Academic Conference of the Chinese Society of Clinical Oncology (CSCO)", Dr. Davide Rossi from the Swiss Institute for Experimental Cancer Research in Bellinzona shared exciting insights on "The Role of Liquid Biopsy (ctDNA) in the Diagnosis and Treatment of Malignant Lymphomas". "Hematology Frontier" specially invited Dr. Davide Rossi for an interview at the venue to further delve into this topic.Hematology Frontier：Liquid biopsy, particularly circulating tumor DNA (ctDNA), has shown promise in the field of oncology. Could you discuss the latest advancements in ctDNA analysis and how they have impacted the diagnosis and treatment of malignant lymphomas?
Dr. Davide Rossi：Thank you very much for your question. I have to say first that the data that we have on liquid biopsy are very exciting but not yet ready or sufficient to be transferred readily into the clinic nowadays. So this still remains, in lymphomas, a research assay. But the aim, of course, is to generate more data to really identify where it can be useful for patient management. Based on the information that we have today, We can say that it may effectively profile gene mutations. So if you want to identify a gene mutation, you can do it on liquid biopsy. It may help in interpreting better the results of PET scans after therapy. These are considerations that we know. How to use this information is less clear and so far, there are no recommendations in guidelines to use ctDNA in practice.
Hematology Frontier: In your experience, how has the integration of liquid biopsy into clinical practice changed the management of patients with malignant lymphomas? What are some of the challenges and limitations that still need to be addressed?
Dr. Davide Rossi：I think that before implementing ctDNA technologies for lymphomas in clinical practice, we need to standardize and harmonize the technology we use to assess this matter, because many different centers use many different approaches. And so, I don’t know actually whether the results would be the same if we share the same sample across the centers. This is an effort that we have to undertake to convince the community. The clinicians, who may not be so deep into the technicalities, that the results of our assays are good enough to be used in patients. So harmonization and standardization is a missing step before launching this in the community. Because ctDNA, as you were mentioning, is a difficult type of DNA and requires careful assays, a careful design of assays for being detected and measured.
Hematology Frontier：Looking ahead, what do you envision as the next big steps in the application of liquid biopsy in the field of malignant lymphoma? Are there any emerging technologies or approaches that you believe will significantly enhance our ability to diagnose and treat these cancers?
Dr. Davide Rossi：For the dialogue diagram for the technology. I think that CAPP-Seq，the method that we use and that other centers in the us in Europe and also in China are using is the one that is more consistent across the community. So this might be a first way to proceed. It is not a commercial essay，is a custom academic diagnostic approach. This is as the value that we know what we are doing and we know how it performs. We know the limitation and the pros and cons. That’s the first aspect. I think that is important to really have the feedback from the community of hematologist on where they see the value for patients in ctDNA as I mentioned before，last year during the Lugano conference，the feeling of the community was that we are not ready for these in the practice or in the guidelines. But there is an ongoing discussion and we will see whether with more data next year in the Lugano meeting on lymphomas, the people has changed their mind. They may be redirected to at least suggest to implement this in every clinical trial to get more Information.
