Changing Paragidms In The Prognostic Assessment Of Hodgkin Lymphoma

Status: Recruiting
Location: See all (12) locations...
Study Type: Observational
SUMMARY

Classical Hodgkin's Lymphoma (cHL) is a rare but highly treatable malignancy of the immune system, primarily affecting young adults. Despite significant therapeutic advancements, frontline treatment failure occurs in up to 30% of cases, with relapse or refractory disease affecting over 50% of these patients. The main therapeutic challenge in cHL remains achieving an optimal balance between disease control and reducing long-term adverse effects. Current prognostic tools only partially capture patient heterogeneity, and cHL continues to evolve spatially and temporally throughout the course of the disease. Personalized treatment strategies require novel integrated tools that better monitor tumor complexity and anticipate disease progression. Fluorodeoxyglucose positron emission tomography (FDG-PET) has improved risk stratification in cHL, as metabolic response during or after chemotherapy strongly correlates with disease progression and survival. However, FDG-PET has limitations, including the absence of standardized criteria and the necessity to initiate treatment before response assessment. To overcome these limitations, molecular profiling and radiomic analysis of baseline FDG-PET data may provide deeper insights into tumor biology, improving prognostic accuracy. This observational study aims to dissect the genetic and phenotypic heterogeneity of cHL at diagnosis and during disease evolution, with the goal of identifying novel prognostic biomarkers. These findings could lead to better treatment personalization, increasing cure rates while minimizing treatment-related toxicity. The study is based on the hypothesis that correlating DNA profiling at diagnosis, gene expression, and radiomic features may enable the identification of high-risk signatures, refining prognostic models in cHL. Additionally, liquid biopsy represents a non-invasive method for assessing tumor mutational complexity. The analysis of circulating DNA (cDNA) throughout disease progression could provide insights into genetic evolution and help predict overt progression before clinical manifestations occur. The primary objective is to define the genetic mutational profile of cHL at disease progression. As secondary objectives, it will evaluate whether liquid biopsy can accurately recapitulate the genetic heterogeneity observed in tumor tissue, determine the predictive accuracy of liquid biopsy in anticipating disease progression, and correlate genomic and radiomic features with patient outcomes to refine risk stratification and therapeutic decision-making. By integrating molecular and imaging-based biomarkers, this study aims to enhance personalized treatment strategies, improve risk-adapted therapeutic approaches, and ultimately optimize curability and quality of life for patients with cHL.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Age \>18 anni

• Written informed consent signed

⁃ Cohort A

• Age \>18 years

• Histologically confirmed diagnosis of relapsed/refractory classical Hodgkin lymphoma identified during induction or follow-up

• Available formalin-fixed, paraffin-embedded (FFPE) biopsy at diagnosis and at the time of progression/relapse

• Available plasma sample at progression (before the beginning of salvage therapy)

• Available FDG-PET evaluation at study enrollment

• Available clinical, laboratory, and radiologic data at diagnosis and relapse

⁃ Cohort B

• Diagnosis of classical Hodgkin lymphoma

• Completion of first-line standard systemic treatment (chemotherapy-based or chemoradiotherapy combined modality)

• Available plasma sample at the end of treatment (at least 30 days from the last chemotherapy)

• Available FFPE biopsy at diagnosis

• No further treatment planned

• Available clinical, laboratory, and radiologic data at diagnosis and response evaluation

• Patient's willingness to undergo 6 months follow-up plasma sample collection and to attend regular follow-up

⁃ Cohort C

• Histologically confirmed diagnosis of classical Hodgkin lymphoma

• Standard treatment as per available guidelines (e.g., ESMO guidelines)

• Available treatment data, response, and follow-up data

• Available FFPE biopsy at diagnosis

• Available FDG-PET evaluation at study enrollment

Locations
Other Locations
Italy
A.O.S.G. Moscati
RECRUITING
Avellino
Spedali Civili Brescia
RECRUITING
Brescia
ASST Grande Ospedale Metropolitano Niguarda
RECRUITING
Milan
Istituto Oncologico Veneto
RECRUITING
Padua
Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello
RECRUITING
Palermo
Azienda Ospedaliera di Perugia
RECRUITING
Perugia
Ospedale S. Maria della Misericordia, Azienda Ospedaliera di Perugia
RECRUITING
Perugia
AUSL Piacenza
RECRUITING
Piacenza
Azienda USL IRCCS di Reggio Emilia
RECRUITING
Reggio Emilia
Azienda Ospedaliera Santa Maria - Terni
RECRUITING
Terni
AOU Città della Salute e della Scienza
RECRUITING
Torino
AOU Città della salute e della Scienza, Le Molinette
RECRUITING
Torino
Contact Information
Primary
Attilio Gennaro, Clinical Research Coordinator
attilio.gennaro@ausl.re.it
+39 0522 295175
Time Frame
Start Date: 2022-06-07
Estimated Completion Date: 2026-12
Participants
Target number of participants: 755
Treatments
Post-Treatment Follow-Up Cohort (Cohort A)
cHL patients who have completed active treatment and entered follow-up.
Relapsed/Progressive Disease Cohort (Cohort B)
cHL patients with a histological confirmation of relapse or disease progression.
Retrospective cHL Cohort (Cohort C)
Consecutive cHL patients from the archives of the Hematology Unit of AUSL-IRCCS, diagnosed between 2004 and 2019 and 250 cHL patients diagnosed between 2016 and 2021 from other Italian hematology centers.
Related Therapeutic Areas
Sponsors
Leads: Azienda USL Reggio Emilia - IRCCS

This content was sourced from clinicaltrials.gov

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