About

Ranjana Advani, MD, is the Saul A. Rosenberg Professor of Lymphoma at Stanford University. She specializes in research and treatment of Hodgkin and non-Hodgkin lymphomas, developing a broad collaborative investigative program that encompasses clinical trials and translational correlates. Dr. Advani serves as the Physician Leader of the Lymphoma Clinical Care Program and is the Principal Investigator on numerous clinical trials. Her research focuses on clinical investigation in Hodgkin's disease, non-Hodgkin's lymphomas, and cutaneous lymphomas, with an emphasis on experimental therapeutics involving novel chemotherapy and biologically targeted therapies. She is actively involved in collaborative efforts with radiation oncology, industry, pathology, and dermatology to advance lymphoma treatment.

Research topics

• Medicine
• Internal medicine
• Oncology
• Surgery
• Biology
• Pathology
• Gastroenterology
• Cancer research
• Family medicine
• Immunology

Selected publications

• Management of Classic Hodgkin Lymphoma in Pregnancy

  Hematology/Oncology Clinics of North America · 2026-02-06 · 1 citations

  articleSenior authorCorresponding
  PublisherDOI

• Treatment Kinetics and Local Response during and after Bridging Radiotherapy prior to CAR-T Cell Therapy for Lymphomas

  International Journal of Radiation Oncology*Biology*Physics · 2025-09-01

  article
  PublisherDOI

• NCCN Guidelines® Insights: B-Cell Lymphomas 3.2025

  Journal of the National Comprehensive Cancer Network · 2025-10-01 · 9 citations

  article

  The treatment landscape of B-cell lymphomas has significantly evolved in recent years with approval of novel targeted therapies. CD3 × CD20 bispecific antibodies and CD19-directed monoclonal antibodies and antibody-drug conjugates have demonstrated efficacy in relapsed/refractory follicular lymphoma (FL). Bruton tyrosine kinase (BTK) inhibitor-based regimens are emerging as effective treatment options for patients with TP53-mutated classical mantle cell lymphoma (MCL). Results from ongoing clinical trials suggest that the addition of CD3 × CD20 bispecific antibodies to chemoimmunotherapy improves outcomes in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL). These NCCN Guideline Insights highlight significant updates to the NCCN Guidelines for B-Cell Lymphomas for the treatment of FL, MCL, and DLBCL.

  PublisherDOI

• Long-term follow-up of venetoclax monotherapy in previously treated patients with Waldenström macroglobulinemia

  Blood Advances · 2025-07-17 · 3 citations

  articleOpen access

  ABSTRACT: Venetoclax is highly active in previously treated Waldenström macroglobulinemia (WM). However, data on the long-term durability and retreatment with venetoclax remain limited. Herein, we present an update of a prospective clinical trial of finite-duration venetoclax on 32 previously treated patients with WM. With a median follow-up of 81 months, 23 patients (72%) had disease progression, 17 (53%) began a new treatment, and 3 (9%) had died. The median progression-free survival (PFS) was 36 months, and the median treatment-free survival (TFS) was 43 months. PFS and TFS were superior in patients who attained at least a partial response to therapy. CXCR4 mutations or previous Bruton tyrosine kinase inhibitor exposure did not impact these outcomes. Of the 17 patients who started a new therapy after completion of venetoclax therapy, 9 were retreated with venetoclax alone or in combination with other treatments (3 attained a very good partial response, 4 attained a partial response, 1 had stable disease, and 1 did not respond). No BCL2 G101V mutations were detected in 52 CD19-selected bone marrow samples from 27 patients during treatment. Venetoclax induced durable responses in WM, thereby enabling retreatment in patients who progressed after completing therapy without the emergence of BCL2 G101V mutations. This trial was registered at www.ClinicalTrials.gov as #NCT02677324.

  PublisherDOI

• External validation of the early-stage classic Hodgkin lymphoma (cHL) international prognostication index (E-HIPI) in the german Hodgkin study group (GHSG) unfavorable clinical trials

  Blood · 2025-11-03

  articleOpen access

  Abstract Background: Although progression-free survival (PFS) in early-stage (ES) classic Hodgkin Lymphoma (cHL) is high, there remains a subset of patients (pts) at higher risk of worse outcomes, particularly in those with unfavorable risk disease. Leveraging pt-level data from within the HoLISTIC (Hodgkin Lymphoma International STudy for Individual Care) Consortium, the E-HIPI was developed in clinical trial pts and validated in real-world registry pts to predict 2-year (y) PFS (Rodday. NEJM Evidence 2025). Continuous, objective, and readily measurable pre-treatment variables were considered, with sex, maximum tumor diameter, albumin, and hemoglobin included as significant predictors. Using the E-HIPI, interactive calculators for pt risk, comparison, and stratification were created (https://rtools.mayo.edu/holistic_ehipi/). Although the E-HIPI was developed and validated in both unfavorable and favorable ES cHL pts, the clinical predictors are primarily markers of unfavorable disease. In the development and initial validation cohorts, 2y PFS was 93.7% and 90.3%, respectively, the C-statistic was 0.63 in both cohorts, calibration was strong with slight underprediction of events in the validation cohort, and the E-HIPI outperformed the historic binary classification of patients as favorable or unfavorable using EORTC criteria. However, since pts in the original E-HIPI development and validation were primarily treated with ABVD chemotherapy protocols, additional validation is needed, particularly among pts with unfavorable ES cHL who were treated initially with more intensive chemotherapeutic platforms (e.g., BEACOPP-based). Thus, we conducted an external validation of the E-HIPI in pts treated on recent unfavorable ES cHL GHSG trials. Methods: The validation cohort included 2367 adults (ages 18 to 60y) with newly-diagnosed unfavorable cHL from randomized phase 3 trials conducted by the GHSG (HD14 von Tresckow. JCO 2012; and HD17 Borchmann. Lancet 2021). We calculated the predicted probability of 2y PFS events based on the E-HIPI model equation (scale 1-100%). Model performance was assessed using discrimination and calibration. Discrimination, which is the model's ability to separate high and low risk pts, was assessed using Harrell's C-statistic. Calibration, which is the model's ability to accurately predict absolute risk, was assessed by comparing observed and predicted probabilities of 2y PFS events within quintiles of predicted probabilities and estimating calibration-in-the-large (predicted minus observed event rate) and the calibration slope. Results: For pts treated on unfavorable GHSG trials, mean age was 33y, 95% had stage II disease, mean baseline E-HIPI score (i.e., predicted 2y PFS event rate) was 6.0% (SD=2.3%), and the observed 2y PFS rate was 96.2% (95%CI: 95.4-97.0%). The C-statistic was 0.65 (95% CI: 0.59-0.70), calibration-in-the-large was 0.02, and the calibration slope was 1.08 (95% CI: 0.52, 1.64). Within the lowest risk E-HIPI quintile, the observed 2y PFS event rate was 1.6%, compared with 6.1% in the highest risk quintile. Conclusions: In external validation of the recently published E-HIPI in pts with cHL treated on unfavorable GHSG trials using more intensive BEACOPP-based protocols, discrimination was similar to the original development and validation cohorts. Collectively, the E-HIPI is a treatment-agnostic prediction tool across varied treatment regimens for unfavorable ES cHL pts. Better 2y PFS in the GHSG trials than in the E-HIPI development and initial validation cohorts may have contributed to mild misclassification, likely reflecting differences in treatment regimens. This may be resolved with recalibration or incorporating granular treatment variables into future models. Additional research is needed to understand E-HIPI performance in pts with favorable disease who have even lower event rates as well as to more fully predict individualized pt outcomes across varied chemotherapy platforms and radiation received for all ES cHL pts.

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• Distinct cell state ecosystems for nodular lymphocyte-predominant Hodgkin lymphoma

  Nature Communications · 2025-09-26

  articleOpen access

  Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare cancer, and few studies have comprehensively investigated the immune microenvironment and rare lymphocyte-predominant (LP) cells. Here we develop a NLPHL specific lymphocyte-predominant ecotype (LPE) model to identify 34 distinct cell states across 14 cell types that co-occur within 3 LPEs for 171 cases. LPE1 and LPE2 were characterized by immunosuppressive microenvironments with high expression of B2M on LP cells, CD8 T-cell exhaustion, immune checkpoint genes expressed by follicular T-cells, and an improved freedom from progression compared to LPE3 in training (n = 109, with 65% LPE1/2) and validation cohorts (n = 62, with 61% LPE1/2). We validate the co-occurrence and co-localization of cell states using spatial transcriptomics. Protein expression of HLA-I and HLA-II on LP cells and SSTR2 on dendritic cells was predictive of LPE1 (C-statistic=0.69), LPE2 (C-statistic=0.79), and LPE3 (C-statistic=0.60). This study establishes a clinically relevant biologic categorization for NLPHL.

  PublisherOA PDFDOI

• Camidanlumab tesirine for relapsed or refractory classic Hodgkin lymphoma: a phase 2 study

  Blood Advances · 2025-08-14 · 5 citations

  articleOpen access

  ABSTRACT: Outcomes in classic Hodgkin lymphoma (cHL) have steadily improved; however, additional therapies are needed for patients who relapse or do not respond to novel agents. Here, we report the efficacy and safety of camidanlumab tesirine (Cami), an anti-CD25 antibody-drug conjugate, in patients with relapsed/refractory cHL after brentuximab vedotin/programmed cell death protein 1 inhibitor therapies from the phase 2 ADCT-301-201 study. Eligible patients were adults with cHL who had received ≥3 previous lines of systemic therapy (or ≥2 if ineligible for hematopoietic stem cell transplant). Patients received 45 μg/kg Cami (IV, once every 3 weeks) in cycles 1 to 2, followed by 30 μg/kg IV once every 3 weeks for ≤1 year. The primary end point was overall response rate (ORR) per 2014 Lugano classification. Secondary end points included complete response rate (CRR), progression-free survival (PFS), and overall survival (OS). In total, 117 patients were enrolled with a median age of 37.0 years (range, 19-87). The ORR was 70.1% (95% confidence interval [CI], 60.9-78.2), with a CRR of 33.3% (95% CI, 24.9-42.6). The median PFS was 9.13 months (95% CI, 5.3-15.0); median OS was not reached. Thirty-three (28.2%) patients discontinued treatment because of treatment-emergent adverse events; the most common reasons were skin and subcutaneous tissue disorders (n = 10 [8.5%] patients), infections and infestations (n = 5 [4.3%]), and nervous systems disorders (n = 5 [4.3%]). Guillain-Barré-type or polyradiculopathy-type events occurred in 8 (6.8%) patients. Cami was efficacious in this heavily pretreated population; however, the efficacy was overshadowed by substantial issues with the safety profile. This trial was registered at www.clinicaltrials.gov as #NCT04052997.

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• Brentuximab vedotin plus chemotherapy for the treatment of front-line systemic anaplastic large cell lymphoma: subgroup analysis of the ECHELON-2 study at 5 years’ follow-up

  Blood Cancer Journal · 2025-08-01 · 4 citations

  articleOpen access

  TRIAL REGISTRATION: ClinicalTrials.gov number: NCT01777152.

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• PET imaging biomarkers predict survival in peripheral T-cell lymphoma: A systematic review and meta-analysis.

  Blood · 2025-11-03

  article

  Abstract Background Peripheral T-cell lymphomas (PTCLs) are aggressive and heterogeneous lymphoid malignancies with poor prognoses and limited response durability using CHOP-based regimens. Recent studies suggest that PET/CT-derived biomarkers—including total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and Deauville scores (DS) at interim and end-of-treatment (EOT)—may hold prognostic value, yet they are not uniformly incorporated into clinical decision-making. As frontline regimens like BV-CHP become more widely adopted, identifying reliable predictors of outcomes is critical. We hypothesized that PET-based biomarkers—TMTV, TLG, and DS—are significantly associated with overall survival (OS) and progression-free survival (PFS) in patients with nodal PTCL treated with CHOP-like or BV-CHP regimens. Methods This systematic meta-analysis (PROSPERO CRD420251041744) identified 196 articles via systematic search of PubMed and Cochrane searches. Inclusion criteria were treatment-naive adults with nodal PTCL treated with CHOP-like BV-CHP regimens studies reporting hazard ratios (HRs) for OS or PFS associated with baseline TMTV, TLG, or DS. Exclusion criteria included case reports, pediatric studies, non-English publications, and studies involving other lymphoma subtypes, ENKTL, cutaneous T-cell lymphomas, and other mature lymphoid neoplasms. Ten studies met the criteria. Five reviewers screened and extracted data. PET variables were dichotomized as study specific threshold of high vs. low (TMTV,) and DS 4–5 vs. 1–3 for interim and EOT comparisons. We conducted Meta-analyses using RevMan 7.2.0 software, inverse-variance methods and random-effects models. Heterogeneity was assessed via I² and τ² (REML). Results Out of 10 eligible studies 9 were retrospective, and ECHELON-2 (E-2) study was prospective with prespecified assessment of PET response using DS. CHOP-like regimens were used in 1075 patients (including 226 from the matched E-2 cohort), while 226 were treated with BV-CHP in E2. The pooled median age was 58.5 years, predominantly male (61.8%) with advanced-stage disease (88.6% Stage III/IV). Patient distribution between low-risk (IPI 0-2) and high-risk (IPI 3-5) groups was balanced. Follow-up duration ranged from 17 to 65.8 months; the estimated pooled median follow-up was 38 months. Baseline TMTV was evaluated in seven studies (n = 680) and was significantly associated with inferior PFS (pooled HR 2.78 [95% CI: 1.24–6.24]; p = 0.01; I² = 88%). Baseline TMTV also correlated with OS across five studies (HR 2.43 [95% CI: 1.49–3.97]; p = 0.0004; I²=83 %). TLG, reported in three studies (n = 254), was associated with worse OS (HR 3.07 [95% CI: 1.29–7.34]; p = 0.01; I² = 73%). Higher baseline SUV was variably associated with OS and PFS across studies, but without consistent statistical significance. DS high at interim PET (6 studies; n = 698) was strongly associated with PFS (HR 3.40 [95% CI: 2.54–4.54]; p < 0.00001; I² = 13%) and OS (HR 3.62 [95% CI: [2.05- 6.38]; p < 0.00001; I²= 65%). DS high at end-of-treatment (EOT) was even more predictive of OS (pooled HR 5.89 [95% CI: 2.15-16.14]; p < 0.0006; I² = 66%) and PFS (HR 4.29 [95% CI: 1.96–9.39]; p < 0.0003; I²=61 %). DS 1–3 was consistently associated with durable remissions, while DS 4–5 often identified primary refractory . Conclusions This meta-analysis confirms that PET-based imaging biomarkers—particularly TMTV, TLG, and DS are significantly associated with OS and PFS in patients with nodal PTCL treated with CHOP or BV-CHP. DS 4–5 at EOT showed the strongest predictive value across cohorts. These findings support incorporating PET biomarkers into clinical risk models and future trials. Limitations include inter-study heterogeneity, mostly retrospective designs, variability in PET methods and cutoff definitions. Prospective validation of optimal cutoffs, and integration with molecular classifiers are needed to refine risk-adapted therapy in PTCL.

  PublisherDOI

• An Individualized Prediction Model for Early-Stage Classic Hodgkin’s Lymphoma

  NEJM Evidence · 2025-06-19 · 3 citations

  articleOpen access

  BACKGROUND: A predictive model for early-stage classic Hodgkin's lymphoma (cHL) does not exist. Leveraging patient-level data from large clinical trials and registries, we developed and validated a model that we term the Early-Stage cHL International Prognostication Index (E-HIPI) to predict 2-year progression-free survival (PFS). METHODS: We developed the model using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) guidelines in 3000 adults with newly diagnosed early-stage cHL from four international phase III clinical trials conducted from 1994 to 2011. External validation was performed in two cohorts, totaling 2360 treated patients from five international cHL registries (1996 to 2019). Two-year PFS was estimated using a Cox model with pretreatment variables selected using backward elimination. Internal validation corrected for overfitting. External validation assessed discrimination and calibration. The final model was also compared against European Organisation for Research and Treatment of Cancer (EORTC) favorable or unfavorable status. RESULTS: The median age in the development cohort was 31.2 years; 77.4% had stage II disease. The estimated 2-year PFS was 93.7%. Final variables retained in the model were sex and continuous values of maximum tumor diameter (MTD), and levels of hemoglobin and albumin. The optimism-corrected C statistic in the development cohort was 0.63 (95% confidence interval, 0.60 to 0.69). Two-year PFS was lower in the validation cohorts 1 (90.3%) and 2 (91.6%). In validation cohort 1, the C statistic was 0.63 and the calibration slope was near 1, but overall calibration indicated underprediction, which improved on updating the intercept. The performance was similar in validation cohort 2. In addition, higher-risk E-HIPI scores were associated with worse outcomes in both the EORTC unfavorable and favorable subgroups. When included altogether in one Cox model, the E-HIPI was associated with PFS, whereas EORTC favorable or unfavorable status was not. Online risk calculators were developed (https://rtools.mayo.edu/holistic_ehipi/). CONCLUSIONS: Utilizing objective, continuous, and readily available variables, we developed and validated a new prediction model for early-stage cHL. Male sex, lower hemoglobin or albumin levels, and higher MTDs were associated with worse PFS. (Funded by the National Cancer Institute; grant number, NCI R01 CA 262265-04.).

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Recent grants

• NIH Grant M01RR000070

  NIH · $27.1M · 2011

Frequent coauthors

• Nancy L. Bartlett

  390 shared

• Michelle A. Fanale

  Pfizer (United States)

  371 shared

• Brad S. Kahl

  306 shared

• Branimir I. Šikić

  Stanford Cancer Institute

  280 shared

• Andrei R. Shustov

  University of Washington

  274 shared

• Elisabeth Paietta

  Montefiore Medical Center

  272 shared

• Peter L. Greenberg

  Stanford University

  271 shared

• Jacob M. Rowe

  Rambam Health Care Campus

  264 shared

Education

• M.D.

  Stanford University

• B.A.

  University of California, Berkeley