Nicholas Short, MD, on Findings from Study Examining NGS-Based MRD Assessment for Patients with ALL

In an interview with CancerNetwork, Nicholas J. Short, MD, of the University of Texas MD Anderson Cancer Center, discussed the findings from his study presented at the 2020 American Society of Hematology (ASH) Annual Meeting.

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So, we were interested in looking at a more highly sensitive MRD assay. And in this case, we looked at next generation sequencing based MRD, which has a sensitivity down to 10 to the minus 6. And typically, in this population, in Philadelphia chromosome negative B cell ALL, we use flow cytometry, this has about 2 log deeper sensitivity. We looked at patients who received any frontline therapy, including lower intensity therapy or more intensive therapy, like with hyper-CVAD.

And we found is that in about 30 to 50% of cases who are otherwise seemingly MRD, negative by flow, we can still detect residual disease by this highly sensitive NGS MRD assay. And importantly, they seem to correlate with clinical outcomes. So those patients who were negative for MRD by this NGS MRD assay, had very low rates of relapse, and excellent long-term survival versus those patients. Obviously, those who are MRD positive by flow, as we already know, had poor outcomes, but those who were MRD negative by flow, but MRD positive by the NGS MRD assay still had suboptimal outcomes. So, the overall conclusion is that this MRD assay may be able to either replace or at least be used in combination with standard MRD measures like flow cytometry.