Dr C. Ola Landgren on Getting Groundbreaking Research Into the Clinic Faster

Minimal residual disease (MRD) may be prevalent in clinical trials and discussed at conferences, but it is not really used widely in practice, said C. Ola Landgren, MD, PhD, professor of medicine and chief of the Myeloma Service at Memorial Sloan Kettering Cancer.

Transcript

How broadly is MRD assessment actually being used in practice?

MRD testing at the current time is not as widely used as you hear at all the meetings. You hear about it all the time from all the clinical trials, but in standard of care, from all I know, it’s not really fully in sync with all the clinical trials. I think there are a couple of barriers. One barrier is, for example, if you use flow cytometry—based approaches for MRD, flow cytometry is an open technology that can be done in many very different ways, and most centers that use it don’t unfortunately use it in full agreement with the guidelines of how it should be. So, patients who are tested at some of these centers are really not MRD negative, they are found to be negative, but they really didn’t look through enough number of cells, so the gating was not done in a manner that the guidelines really say.

When it comes to the sequencing-based technologies, which I do think will probably be the future very soon, there are already FDA-cleared assays for this, those technologies are available, but currently only for send out. I think when they become available for local use at the individual centers, I think that will completely change the field. And it could also send out probably to more centers across the country and internationally as well that could also be another way of doing it. So, I think basically access will drive that.