Liquid biopsy for improving diagnosis and monitoring of CNS lymphomas: A RANO review

Author:

Nayak Lakshmi1,Bettegowda Chetan2,Scherer Florian3ORCID,Galldiks Norbert4ORCID,Ahluwalia Manmeet5,Baraniskin Alexander6,von Baumgarten Louisa78ORCID,Bromberg Jacoline E C9ORCID,Ferreri Andrés J M10,Grommes Christian1112,Hoang-Xuan Khê13,Kühn Julia14,Rubenstein James L15,Rudà Roberta16,Weller Michael17ORCID,Chang Susan M18,van den Bent Martin J19ORCID,Wen Patrick Y20ORCID,Soffietti Riccardo2021ORCID

Affiliation:

1. Dana-Farber Cancer Institute, Harvard Medical School , Boston, Massachusetts , USA

2. Department of Neurosurgery, Johns Hopkins University School of Medicine , Baltimore, Maryland , USA

3. Department of Medicine I, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg , Freiburg , Germany

4. Department of Neurology, University of Cologne, Medical Faculty and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), and Institute of Neuroscience and Medicine (INM-3), Research Center Juelich , Juelich , Germany

5. Rose and Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland OH and Miami Cancer Institute, Baptist Health South Florida, International University , Miami, Florida , USA

6. Department of Hematology, Oncology and Palliative Care, Evangelisches Krankenhaus Hamm , Hamm , Germany

7. Department of Neurosurgery, Ludwig-Maximilians—University of Munich , Munich , Germany

8. German Cancer Consortium, Partner Site Munich , Munich , Germany

9. Erasmus MC University Medical Center Cancer Center , Rotterdam , The Netherlands

10. Università Vita-Salute San Raffaele and IRCCS San Raffaele Scientific Institute , Milano , Italy

11. Department of Neurology, Memorial Sloan Kettering Cancer Center , New York, New York , USA

12. Department of Neurology, Weill Cornell Medical College , New York, New York , USA

13. APHP, Department of Neuro-oncology, Groupe Hospitalier Pitié-Salpêtrière; Sorbonne Université, Paris Brain Institute ICM , Paris , France

14. Department of Medicine I, Faculty of Medicine, Medical Center University of Freiburg, University of Freiburg , Freiburg , Germany

15. UCSF Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center , San Francisco, California , USA

16. Division of Neuro-Oncology, Department of Neuroscience “Rita Levi Montalcini,” University of Turin , Turin , Italy

17. Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich , Zurich , Switzerland

18. Department of Neurosurgery and Division of Neuro-Oncology, University of California , San Francisco, California , USA

19. Erasmus MC Cancer Institute , Rotterdam , The Netherlands

20. Department of Neuroscience “Rita Levi Montalcini,” University of Turin , Turin , Italy

21. Candiolo Cancer Institute, FPO-IRCCS , Turin , Italy

Abstract

Abstract Background The utility of liquid biopsies is well documented in several extracranial and intracranial (brain/leptomeningeal metastases, gliomas) tumors. Methods The RANO (Response Assessment in Neuro-Oncology) group has set up a multidisciplinary Task Force to critically review the role of blood and cerebrospinal fluid (CSF)–liquid biopsy in CNS lymphomas, with a main focus on primary central nervous system lymphomas (PCNSL). Results Several clinical applications are suggested: diagnosis of PCNSL in critical settings (elderly or frail patients, deep locations, and steroid responsiveness), definition of minimal residual disease, early indication of tumor response or relapse following treatments, and prediction of outcome. Conclusions Thus far, no clinically validated circulating biomarkers for managing both primary and secondary CNS lymphomas exist. There is need of standardization of biofluid collection, choice of analytes, and type of technique to perform the molecular analysis. The various assays should be evaluated through well-organized central testing within clinical trials.

Publisher

Oxford University Press (OUP)

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