Measurable residual disease in chronic lymphocytic leukemia

Frontiers in Oncology

Oncology

Federico Pozzo¹  Valter Gattei¹  Francesco Autore²  Idanna Innocenti²  Alberto Fresa²  Giulia Benintende³  Luca Laurenti³  Giovanni D’Arena⁴ 

[1] Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy;Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy;Sezione di Ematologia, Dipartimento di Scienze Radiologiche ed Ematologiche, Università Cattolica del Sacro Cuore, Rome, Italy;“San Luca” Hospital, Azienda Sanitaria Locale (ASL) Salerno, Salerno, Italy;

关键词: measurable residual disease;    chronic lymphocytic leukemia;    flow cytometry;    ASO-PCR;    next generation sequencing;    surrogate endpoint;   

DOI  :  10.3389/fonc.2023.1112616

 received in 2022-11-30, accepted in 2023-01-24,  发布年份 2023

来源: Frontiers

【 摘 要 】

Measurable residual disease (MRD) is defined as the presence of residual cancer cells after treatment in patients with clinically undetectable disease, who would otherwise be considered in complete remission. It is a highly sensitive parameter which indicates the disease burden and predicts survival in this setting of patients. In recent years, MRD has gained a role in many hematological malignancies as a surrogate endpoint for clinical trials: undetectable MRD has been correlated to longer progression free survival (PFS) and overall survival (OS). New drugs and combinations have been developed with the aim to achieve MRD negativity, which would indicate favorable prognosis. Different methods to measure MRD have also been devised, which include flow cytometry, polymerase chain reaction (PCR) and next generation sequencing (NGS), with different sensitivity and accuracy in evaluating deep remission after treatment. In this review, we will analyze the current recommendations for the detection of MRD, with particular focus on its role in Chronic Lymphocytic Leukemia (CLL), as well as the different detection methods. Moreover, we will discuss the results of clinical trials and the role of MRD in new therapeutic schemes with inhibitors and monoclonal antibodies. MRD is not currently used in the clinical practice to evaluate response to treatment, due to technical and economical limitations, but it’s gaining more and more interest in trials settings, especially since the introduction of venetoclax. The use of MRD in trials will likely be followed by a broader practical application in the future. The aim of this work is to provide a reader-friendly summary of the state of art in the field, as MRD will soon become an accessible tool to evaluate our patients, predict their survival and guide physician’s therapeutic choices and preferences.

【 授权许可】

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Copyright © 2023 Benintende, Pozzo, Innocenti, Autore, Fresa, D’Arena, Gattei and Laurenti