Plasma and serum biomarkers for Hodgkin lymphoma

描述(申请人提供)：晚期霍奇金淋巴瘤(HL)通常是治愈的。然而，仍然有很大一部分患者治疗失败，以及其他人出现晚期、有时是致命的治疗并发症。强化治疗方案导致较高的一期治愈率，但代价是更多的继发性恶性肿瘤，生育能力丧失， 以及其他长期毒性。有一种不那么密集的方案，可以产生更少的前期治疗，更少的第二次恶性肿瘤，更少的生育损失和更少的长期毒性。在考虑到抢救治疗的结果后，这两种方法产生的长期总存活率非常相似。如果有可能只针对高危患者进行更强化的治疗，那么与更强化治疗相关的前期治愈率可能保持不变，而在那些未进行强化治疗的患者中，第二种恶性肿瘤和其他毒性可能被降至最低。在这一试点应用中，我们的重点是评估先前确定的基于血液的分子标志物作为晚期HL患者反应和预后的预测因子。我们寻求扩大分子标记的评估范围，以包括可能对指导治疗决策最有帮助的早期时间点。待研究的标记将包括EBV DNA、sCD30、TARC、sCD163和sBLyS。我们还将评估EBV DNA检测的改进，我们预计这将减少与无细胞血液标准测量相关的噪音。拟议的研究将在一项大型随机合作小组研究(E2496)的背景下进行，该研究比较了ABVD和Stanford V。该研究是完整的，临床和病理注释，并可获得长期结果。

DESCRIPTION (provided by applicant): Advanced stage Hodgkin lymphoma (HL) is usually cured. However, there remains an important fraction of patients who fail therapy, and others who develop late, sometimes fatal, complications of therapy. An intensive treatment regimen results in a higher up front cure rate but at the cost of more second malignancies, fertility loss, and other long-term toxicities. There is a less intensive regimen that yields fewer upfront cures, fewer second malignancies, less fertility loss and fewer long-term toxicities. After taking the result of salvage therapies into account, the approaches generate very similar long term overall survival. If it were possible to target only high risk patients to the more intensive therapy, the upfront cure rate associated with the more intensive therapy might be maintained, while the second malignancies and other toxicities might be minimized in those patients not treated intensively. Our focus in this pilot application is to evaluate previously identified blood-based molecular markers as predictors of response and outcome in patients with advanced HL. We seek to extend the evaluation of molecular markers to include early time points that might be most helpful in guiding decisions about therapy. The markers to be studied will include EBV DNA, sCD30, TARC, sCD163 and sBLyS. We also will evaluate an EBV DNA assay refinement that we anticipate will diminish the noise associated with standard measurements in cell-free blood. The proposed studies will be carried out in the context of a large randomized cooperative group study (E2496) comparing ABVD and Stanford V. The study is complete, clinical and pathologic annotation, and long term outcomes are available.