Longitudinal Assessment Of Circulating Tumor Mutational Burden Using A Next-Generation Sequencing Cancer Gene Panel: A Potential Biomarker Of Response To Programmed Cell Death 1 (Pd-1) Blockade In Patients With Relapsed/Refractory Classical Hodgkin Lymphoma

Introduction: The programmed cell death 1 (PD-1) monoclonal antibodies (MoAbs) nivolumab and pembrolizumab induce response rates exceeding 70% in relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). The lack of response to PD-1 MoAbs, and the relapse occurring in most patients who had responded to PD-1 blockade suggest that tools to identify the determinants of response/resistance to PD-1 MoAbs are urgently required. We hypothesized that the characterization of the mutational profile of circulating tumor DNA (ctDNA) could represent a valuable tool to track clonal evolution-driven resistance to checkpoint inhibitors.