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

Lakshmi Nayak; Chetan Bettegowda; Florian Scherer; Norbert Galldiks; Manmeet Ahluwalia; Alexander Baraniskin; Louisa von Baumgarten; Jacoline E C Bromberg; Andrés J M Ferreri; Christian Grommes; Khê Hoang-Xuan; Julia Kühn; James L Rubenstein; Roberta Rudà; Michael Weller; Susan M Chang; Martin J van den Bent; Patrick Y Wen; Riccardo Soffietti

doi:10.1093/neuonc/noae032

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

Neuro Oncol. 2024 Apr 10:noae032. doi: 10.1093/neuonc/noae032. Online ahead of print.

Authors

Lakshmi Nayak¹, Chetan Bettegowda², Florian Scherer³, Norbert Galldiks⁴, Manmeet Ahluwalia⁵, Alexander Baraniskin⁶, Louisa von Baumgarten⁷, Jacoline E C Bromberg⁸, Andrés J M Ferreri⁹, Christian Grommes¹⁰, Khê Hoang-Xuan¹¹, Julia Kühn¹², James L Rubenstein¹³, Roberta Rudà¹⁴, Michael Weller¹⁵, Susan M Chang¹⁶, Martin J van den Bent¹⁷, Patrick Y Wen¹⁸, Riccardo Soffietti¹⁹

Affiliations

¹ Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
² Johns Hopkins University School of Medicine, Department of Neurosurgery.
³ Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, 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 FL, 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 & German Cancer Consortium, Partner Site Munich, Munich, Germany.
⁸ Erasmus MC University Medical Center Cancer Center, Rotterdam, The Netherlands.
⁹ Università Vita-Salute San Raffaele and IRCCS San Raffaele Scientific Institute, Milano, Italy.
¹⁰ Christian Grommes, Department of Neurology, Memorial Sloan Kettering Cancer Center, New York and Department of Neurology, Weill Cornell Medical College, New York, USA.
¹¹ APHP, Department of Neuro-oncology, Groupe Hospitalier Pitié-Salpêtrière; Sorbonne Université; Paris Brain Institute ICM; Paris France.
¹² Department of Medicine I, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
¹³ UCSF Hematology/Oncology, Helen Diller Family Comprehensive Cancer Center San Francisco, CA, USA.
¹⁴ Division of Neuro-Oncology, Dept. Neuroscience 'Rita Levi Montalcini', University of Turin, Turin, Italy.
¹⁵ Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland.
¹⁶ Department of Neurosurgery and Division of Neuro-Oncology, University of California, San Francisco, USA.
¹⁷ Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
¹⁸ Center for Neuro-Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
¹⁹ Department of Neuroscience 'Rita Levi Montalcini' University of Turin (R.S.); Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy.

PMID: 38598668
DOI: 10.1093/neuonc/noae032

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 CSF-liquid biopsy in central nervous system 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, steroids 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.

Keywords: CSF biomarkers; MYD88 mutations; circulating tumor DNA; primary CNS lymphomas; secondary CNS lymphomas.

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