Dr Abramson on ASCO 2025 DLBCL Updates: What's New?

Jeremy S. Abramson, MD, director of the Jon and Jo Ann Hagler Center for Lymphoma at the Massachusetts General Hospital Cancer Center, and associate professor of medicine at Harvard Medical School, in Boston, Massachusetts, discusses pivotal advancements in diffuse large B-cell lymphoma (DLBCL) from the 2025 American Society of Clinical Oncology Annual Meeting.

Abramson highlights the PhasED-Seq assay for minimal residual disease (MRD) testing as a potentially "practice-changing" development for the future. He reviews a large population-based analysis demonstrating its powerful prognostic value at the end of DLBCL treatment. Patients who were MRD undetectable by PhasED-Seq showed an "extremely high likelihood of cure" and a "very low likelihood of relapse." Conversely, those who remained MRD detectable faced an "extraordinarily high likelihood of progressing within the subsequent 6 months," representing a high-risk population.

He emphasizes that PhasED-Seq proved more prognostic than baseline IPI scores or end-of-treatment PET-CT scans. While not yet standard practice, Abramson believes MRD detection, particularly with PhasED-Seq, will add value to post-treatment imaging. This critical area is currently being explored in prospective clinical trials, signaling a new frontier in DLBCL management.

Transcription:

0:10 | ​​So I think the most potentially practice-changing in the future is the role of MRD testing using the PhasED-Seq assay. We saw a large population-based analysis of prospectively collected data in diffuse large B-cell lymphoma, looking at the prognostic value of PhasED-Seq at the end of treatment for diffuse large B-cell lymphoma, and what that assay showed is that patients who are MRD undetectable on the PhasED-Seq assay had an extremely high likelihood of cure and a very low likelihood of relapse, whereas those patients who remained MRD detectable at the end of treatment had an extraordinarily high likelihood of progressing within the subsequent 6 months. And so those patients represent an extremely high-risk population for relapse and ultimately are a population we should be targeting before they manifest with obvious disease on imaging, and the PhasED-Seq assay proved more prognostic and more powerful at predicting prognosis than baseline IPI scores or end-of-treatment PET CT.

1:21 | So I think that the PhasED-Seq assay and MRD detection in general will add significant value to post-treatment imaging and ultimately will hopefully prove a platform for treatment of MRD detectability as primary refractory disease with early incorporation of immunotherapies. And that's a question that's currently being addressed in prospective clinical trials. So while it's not practice changing today, I think it does represent the future.