Merryman Discusses the Role of MRD in Lymphoma Care and Trials

Reid Merryman, MD, clinical investigator and assistant professor at Dana-Farber Cancer Institute, discusses which patients are typically monitored for minimal residual disease (MRD) and whether there are specific subtypes or stages where the assessment is particularly critical.

In addition, Merryman explains how MRD is currently being used in clinical trials.

Transcription:

0:09 | I would say for lymphoma, if we take out [chronic lymphocytic leukemia (CLL)] for lymphoma right now, MRD is not a standard part of clinical practice. We really need prospective, randomized, phase 3 trials to let us know how best to use MRD to guide treatment. So, outside of trials and clinics, I am not testing MRD for my [patients with] lymphoma.

0:32 | So, I think we are seeing a lot of trials tracking MRD. I would say that almost all trials now are building a collection of plasma samples so that they can look and see how MRD changes with treatment. And we are just starting to see trials that are using MRD to guide therapies. I think there are a few different ways that MRD can be used. So, we can look at changes in MRD at an early time point and then use that to either deescalate therapy or escalate therapy, depending on the MRD status, or, we can use it to guide consolidation, like that mantle cell lymphoma trial I talked about. So, at the end of treatment, we can look at MRD results and we can decide whether we should or should not do additional treatment. There are also some trials that are testing MRD serially and using that to decide when we can stop treatment, and in some cases, when we should restart treatment if MRD emerges. Those are kind of 3 patterns of trials for how to use MRD.