A recent real-world analysis demonstrated that the use of minimal residual disease (MRD) assessment is growing in the routine management of patients with hematological malignancies.

Findings from the study, led by Audrey Demaree, PharmD, of Adaptive Biotechnologies in Seattle, Washington, and colleagues were published in an abstract associated with the National Comprehensive Cancer Network (NCCN) 2020 Annual Conference, which was postponed in response to the coronavirus disease 2019 (COVID-19) pandemic.

In recent years, the NCCN has updated its clinical practice guidelines to include MRD assessment for multiple myeloma (MM), acute lymphocytic leukemia (ALL), and chronic lymphocytic leukemia (CLL).

Currently, the clonoSEQ® Assay (Adaptive Biotechnologies; Seattle, WA) is the only MRD test for bone marrow assessment in patients with B-cell ALL and MM approved by the US Food and Drug Administration.


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Using the Adaptive Biotechnologies database of clonoSEQ clinical samples, the team sought to characterize the use of MRD assessment in patients with MM and B-cell ALL in the real-world care setting. The dataset comprised de-identified data from samples assessed between January 2018 to October 2019. A patient’s data were included in the study if a trackable sequence was identified in the clonality assessment at baseline. The analysis included  patient demographics, MRD testing patterns, and deepest level of MRD response achieved.

In total, data from 2073 patients were evaluated, including 1369 patients with MM and 704 patients with B-cell ALL. The median age was 65 years for patients with MM and 25 years for patients with B-cell ALL, which according to the authors, are consistent with epidemiologic data.

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Overall, 47.5% of patients with MM and 78.4% of patients with B-cell ALL reached an MRD response of at least 10-5, and many patients even achieved response below 10-6, 30.6% of MM patients and 68.7% of B-cell ALL patients.

“Given the association between MRD levels and long-term outcomes demonstrated across clinical trials and meta-analyses in lymphoid cancers, the ability to capture and report patient MRD values using a quantitative and standardized assay in a large real-world population presents important opportunities for understanding lymphoid cancer population health, and performing comparative effectiveness and other RWE studies,” the authors concluded.

Reference

Demaree A, Hewitt A, Eckert B, Lee L. CLO20-035: real-world minimal residual disease (MRD) assessment and trends using clonoSEQ in B-cell acute lymphoblastic leukemia and multiple myelomaJ Natl Compr Canc Netw. 2020;18(3.5):CLO20-035-CLO20-035.