Dr Lindsey Roeker on Using MRD for Decision Making

So far, minimal residual disease (MRD) has not been used much outside of clinical trials, but researchers are testing how it might be used to guide decisions in clinical practice, said Lindsey Roeker, MD, clinical fellow at Memorial Sloan Kettering Cancer Center.

Transcript

How can MRD being used to tailor therapy for patients with CLL? And is this being used in the real-world or most in clinical trials?

MRD, really at this point, has been a tool used for decision making in the context of clinical trials. More challenging in clinical practice, just given availability of testing and all of these things. So, right now I think the major use is in clinical trials, but I think as we know more about how MRD should inform our decision making it will become more a piece of clinical practice.

You were part of a team of authors on an abstract proposing a trial to assess MRD for the purpose of guiding clinical decision making. What was involved in that trial design and how would it help guide future decisions?

So, this is a really exciting study. We’re looking at patients who’ve [received a] commercial supply of venetoclax, either alone or in combination with a CD20 antibody, and 4 patients who have received this therapy will be testing MRD. And if patients have really achieved a deep level of response, they’ll be able to come off drug, and we’ll monitor MRD serially. We’re going to wait until patients really progress to re-treat the with venetoclax, but we will be seeing what the kinetics of that MRD is after stopping venetoclax.