MRD is the new standard in blood cancer care
Treatment responses in lymphoid malignancies are deeper than ever, illuminating the need for advanced MRD detection
Expert insights on MRD
Dr. Jeffrey Wolf discusses MRD
This video was filmed by the Video Journal of Hematological Oncology (VJHemOnc) for use on VJHemonc.com. Adaptive Biotechnologies contributed to the video’s development and approval.
ASH 2020 Product Theater: Lanny Kirsch, MD
Watch a live presentation from ASH 2020 titled clonoSEQ and MRD Assessment in the Management of Lymphoid Malignancies.
OncLive Peer Exchange
Content was developed independently by OncLive. This OncLive Peer Exchange was funded, in part, via a grant from Adaptive. Used by permission from OncLive.
What is MRD?
Minimal Residual Disease
Minimal residual disease (MRD) refers to the small number of cancer cells that can remain in a patient’s body during and after treatment and may eventually cause recurrence of the disease. These residual cells typically cause no physical signs or symptoms and are present at such low levels that more refined and sensitive techniques are required to identify them.
Monitoring MRD at various points throughout the course of treatment and remission provides important insight into the status of a patient’s disease in lymphoid malignancies like chronic lymphocytic leukemia, multiple myeloma, and acute lymphoblastic leukemia.[1-7]
How is MRD measured?
Advanced technologies are improving clinicians’ ability to confidently monitor MRD
Lurking cancer cells may go undetected.
Clinicians have been evaluating residual disease in lymphoid cancers for decades, but historically, MRD assessment lacked the precision and sensitivity to identify and track disease at the low levels where disease often lurks.
Among conventional MRD detection methods, no single test offered the deepest levels of sensitivity, an accurate quantification of disease burden, and the standardization necessary to provide clinicians with confidence in the results.
Cancer cells that may have been
missed can now be detected.
Recent advancements in MRD testing, driven by development of the clonoSEQ® Assay, have enabled precise identification and quantitation of the specific DNA sequences associated with lymphoid malignancy, empowering clinicians to accurately and reliably assess a patient’s MRD status at any point during treatment or remission.[9,10]
Why measure MRD?
Accurate MRD assessment can guide clinicians in developing personalized treatment approaches
The enhanced ability to monitor MRD has the potential to inform patient management decisions in several important ways:
MRD assessment can help predict clinical outcomes
Given the nature of current therapies, some patients will achieve remission of their disease while others ultimately relapse. The goal of utilizing MRD in patient management is to be able to detect residual disease at the lowest level possible in order to be confident in a patient’s MRD status. Data demonstrates that deep MRD negativity correlates with improved outcomes. As a result, clinicians can use MRD test results to assess a patient’s response to treatment, which may inform decisions made throughout the treatment continuum.[9,10]
MRD enables early detection of relapse
Quantitative MRD assessment may identify progression of disease much sooner than the onset of physical signs and symptoms. The more sensitive the MRD detection assay, the sooner impending relapse can be identified. This “lead time” gained by not waiting until physical signs and symptoms emerge may allow a clinician to intervene earlier to regain control of a patient’s disease.
Deep sensitivity enables early detection of relapse, allowing for possible early intervention
This page is intended for a US-based audience.
clonoSEQ® is available as an FDA-cleared in vitro diagnostic (IVD) test service provided by Adaptive Biotechnologies to detect minimal residual disease (MRD) in bone marrow from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (B-ALL) and blood or bone marrow from patients with chronic lymphocytic leukemia (CLL). Additionally, clonoSEQ is available for use in other lymphoid cancers and specimen types as a CLIA validated laboratory developed test (LDT). IGHV testing is available as a CLIA-validated LDT and has not been cleared or approved by the FDA. For important information about the FDA-cleared uses of clonoSEQ including test limitations, please visit clonoSEQ.com/technical-summary.
- Pulsipher M, et al. Blood. 2015;125(22):3501-3508.
- Perrot A, et al. Blood. 2018;132(23):2456-2464.
- Al-Sawaf O, et al. Lancet Oncol. 2020;21(9):1188-1200.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Pediatric Acute Lymphoblastic Leukemia V.3.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 23, 2021. To view the most recent and complete version of the guideline, go to NCCN.org.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Lymphoblastic Leukemia V.2.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 23, 2021. To view the most recent and complete version of the guideline, go to NCCN.org.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Multiple Myeloma V.7.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 23, 2021. To view the most recent and complete version of the guideline, go to NCCN.org.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia V.4.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 23, 2021. To view the most recent and complete version of the guideline, go to NCCN.org.
- Sherrod AM, et al. Bone Marrow Transplant. 2015;51:2-12.
- clonoSEQ®. [technical summary]. Seattle, WA: Adaptive Biotechnologies; 2020. https://clonoseq.com/technical-summary.
- Ching T, et al. BMC Cancer. 2020;20:612.
- Logan AC, et al. Biol Blood Marrow Transplant. 2014;20(9):1307-1313.