Precise-HL trial: Personalized reduction of chemotherapy intensity through ctdna evaluation in advanced Hodgkin lymphoma

作者：Ryan C. Lynch, David A. Russler‐Germain, Joseph G. Schroers‐Martin, Alison J. Moskowitz, Reid W. Merryman, Azra Borogovac, Hongyan Du, Heather Rasmussen, Ranjana H. Advani, Ash A. Alizadeh, Philippe Armand, Nancy L. Bartlett, Alex F. Herrera, Matthew Mei, Sarah C. Rutherford, David M. Kurtz, Ted Gooley, Jenna Voutsinas, Ajay K. Gopal · 发表于：Blood · 年份：2025 · DOI：10.1182/blood-2025-5408 · 被引用次数：3 · 研究领域：Lymphoma Diagnosis and Treatment、Cancer Immunotherapy and Biomarkers、Cancer Genomics and Diagnostics

Abstract Introduction Nivolumab-AVD has become a new standard for untreated advanced stage Hodgkin lymphoma in North America. However, future directions to improve outcomes in these patients are not defined at this time and may be challenging based on the excellent outcomes for patients treated with this regimen. While most patients achieve a cure, the data over the past decade has confirmed dose dependent risks of anthracycline exposure independent of mediastinal radiation, particularly in younger patients (van Wimnegen et al Blood 2017). Efforts to maintain high cure rates while limiting toxicity are warranted. Data using phased variant enrichment and detection sequencing (PhasED-Seq) for measurable residual disease (MRD) assessment in classic Hodgkin lymphoma (CHL) suggests that the majority of patients receiving first line therapy clear circulating tumor DNA early with PD1-inhibitor-based combination approaches (Lynch et al ASH 2024, Alig et al Nature 2023, Herrera et al. ICML 2025). The PRECISE-HL trial will assess a response-adaptive CHL treatment approach utilizing PhasED-Seq to reduce the overall chemotherapy burden for patients with early MRD-negativity when treated with nivolumab-AVD (NCT06745076). Methods This is a multi-center phase 2, open label pilot study of six cycles of response-adapted therapy based on MRD testing by PhasED-Seq for untreated stage III or IV CHL. First patient was enrolled in February 2025. Patients will receive the combination of nivolumab (...