Focus on MRD: current landscape and future questions in hemonc
Jul 4, 2018
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Experts from various institutions discuss Measurable Residual Disease (MRD) in the field of hemonc. They explore the role of MRD as a prognostic factor, novel technologies for MRD detection, and MRD measurement as a strategy for treatment-free survival. Recorded at several conferences, this podcast dives into the exciting realm of MRD in cancer management.
MRD measurement can help determine treatment efficacy, disease prognosis and guide disease management.
Next-generation sequencing (NGS) is considered the superior technology for MRD assessment due to its higher sensitivity and reproducibility compared to flow cytometry.
Deep dives
Utilization of MRT in the Clinical Setting
Utilizing MRT (measurable residual disease) in the clinical setting has become a reality that is now featured as an endpoint in clinical trials. The first fundamental step is to codify and reach consensus on the definitions of CR (complete remission) and PR (partial remission), as well as determine the relevance of PR. Additionally, the incorporation of molecular biology and genetic mutations into response definitions is necessary to improve treatment decision-making. This would enable the rationing of selected agents for patients with measurable residual disease, potentially leading to personalized therapies and the role of bone marrow transplantation in improving patient outcomes.
MRD as a Prognostic Factor and Treatment Guide
MRD has emerged as one of the most important prognostic factors in AML (acute myeloid leukemia). By detecting MRD using next-generation sequencing or flow cytometry, treatment protocols can be tailored to focus toxic treatments on patients who will benefit the most. This approach aims to improve outcomes and reduce the long-term side effects of treatment, especially for patients undergoing bone marrow transplants. Incorporating molecular diagnostics and targeted therapies based on MRD results provides a promising approach for individualized treatment.
Next-Generation Sequencing for MRD Detection
Next-generation sequencing (NGS) is considered the superior technology for MRD assessment due to its higher sensitivity and reproducibility compared to flow cytometry. Although challenges such as the need for baseline samples and turnaround times exist, NGS offers targeted molecular diagnostics that can guide treatment decisions. The future of MRD includes exploring its use beyond upfront settings and considering it as a strategy for treatment-free survival. Further research is needed to determine if MRD-negative patients can safely discontinue maintenance therapy and if reinitiating therapy upon loss of MRD negativity is beneficial.
Measurable residual disease (MRD) has been a hot topic of interest due to its potential applications in the clinical setting. MRD measurement can help determine treatment efficacy, disease prognosis and guide disease management. In this podcast, Bijal Shah of the H. Lee Moffitt Cancer Center & Research Institute in Tampa, Richard Dillon from King’s College London, Todd Druley of Washington University School of Medicine in St. Louis and Ola Landgren of Memorial Sloan Kettering Cancer Center explore the exciting realm of MRD.
The role of MRD as a prognostic factor, the novel technologies that can be used to detect MRD, the next steps in utilizing this measure and MRD measurement as a strategy for treatment-free survival are among the stimulating areas considered. This footage was recorded at the International Workshop on Acute Leukemias (iwAL) 2018, the British Society for Haematology (BSH) 2018 Annual Meeting, the American Society for Hematology (ASH) Annual Meeting and Exposition 2016 and 2017, and the European Hematology Association (EHA) Congress 2018.