MINIMAL RESIDUAL DISEASE (MRD)

The persistence of cancerous cells after treatment, known as minimal (or measurable) residual disease, may lead to relapse

Even after remission, small traces of malignant cells that remain can lead to relapse, limited treatment options, and poor patient outcomes1-3


Evolving science and knowledge of MRD as a prognostic indicator is shaping treatment choices and overall patient management4,5


As part of our ongoing commitment to improving patient outcomes, Amgen continues to explore innovative approaches for eradicating MRD across multiple hematologic malignancies. Amgen is leading the way in MRD+ B-cell precursor ALL and is committed to advancing the science to fulfill our mission of serving patients.

Learn more about MRD at:

Detecting MRD: testing methods and sensitivity6,7

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Flow cytometry

A rapid and qualitative method of identifying cancer cells

SENSITIVITY:
1 cancer cell in
10,000 normal cells6
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Polymerase chain reaction

A well-established method in which a specific section of DNA from cancer cells is replicated and amplified

SENSITIVITY:
1 cancer cell in
100,000 normal cells6
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Next-generation sequencing

An extremely sensitive DNA sequencing method

SENSITIVITY:
1 cancer cell in
1,000,000 normal cells7

Where is your nearest MRD testing facility?

The link below is an informational resource to help healthcare providers locate MRD testing facilities for clinically appropriate patients. Amgen does not refer, recommend, or endorse healthcare providers or facilities listed here. The selection of a healthcare provider is a patient's choice and should be carefully considered. Please contact facilities directly to learn more about the availability of MRD testing at these locations.

Download the list

MRD IN ACUTE LYMPHOBLASTIC LEUKEMIA

Adults with B-cell precursor acute lymphoblastic leukemia (ALL) who achieve CR may still relapse1,8

Going deeper by measuring MRD

MRD is an important prognostic indicator that may be useful for predicting relapse3

In adult B-cell ALL:

  • Up to half of adult patients relapse after achieving complete remission with standard-of-care chemotherapy1,8
    • This can lead to poor long-term outcomes and fewer treatment options1,2
  • 70% of patients who relapse are unlikely to achieve CR2 when treated with chemotherapy1
NCCN Guidelines® recommend testing for MRD9

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for ALL recommends MRD assessment upon completion of initial induction therapy and states9: "MRD is an essential component of patient evaluation over the course of sequential therapy"

Get more facts about MRD testing in your practice

*According to a meta-analysis of 5 studies evaluating 806 adult patients with ALL.

CR: complete response; CR2: second complete response.

Over a 10 year period, patients who achieved MRD negativity had a greater chance of survival vs patients who remained MRD+4*

For a range of additional materials about MRD, visit our resources or tap on any thumbnail below to view.

Acute Lymphoblastic Leukemia and Minimal Residual DiseaseCurrent Landscape in Minimal residual Disease (MRD) Testing in Hematologic MalignanciesFacilities Conducting MRD TestingTesting for Minimal Residual Disease (MRD) after complete remissionMinimal Residual Disease in Hematologic MalignanciesMinimal Residual Disease video
References

1. Jain N, et al. In: Hoffman R, et al, eds. 6th ed. Philadelphia, PA: Saunders-Elsevier; 2013:960-980. 2. Gökbuget N, Kneba M, Raff T, et al. Adult patients with acute lymphoblastic leukemia and molecular failure. Blood. 2012;120(9):1868-1876. 3. Pettit K, Stock W, Walter RB. Incorporating measurable ("minimal") residual disease-directed treatment strategies to optimize outcomes in adults with acute myeloid leukemia. Leuk Lymphoma. 2016;57(7):1527-1533. 4. Berry DA, Zhou S, Higley H, et al. Association of minimal residual disease with clinical outcome in pediatric and adult acute lymphoblastic leukemia: a meta-analysis. JAMA Oncol. 2017;3:e170580. doi:10.1001/jamaoncol.2017.0580. 5. Harousseau J-L, Avet-Loiseau H. Minimal residual disease negativity is a new end point of myeloma therapy. J Clin Oncol. 2017;35(25):2863-2865. 6. Campana D. Semin Hematol. 2009;46(1):100-106. 7. Ladetto M, Brüggemann M, Monitillo L, et al. Next-generation sequencing and real-time quantitative PCR for minimal residual disease detection in B-cell disorders. Leukemia. 2014;28(6):1299-1307. 8. Hoelzer D. Monitoring and managing minimal residual disease in acute lymphoblastic leukemia. Am Soc Clin Oncol Educ Book. 2013;33:290‐293. doi:10.1200/EdBook-AM.2013.33.290. 9. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Lymphoblastic Leukemia V.5.2017. © National Comprehensive Cancer Network, Inc. 2017. All rights reserved. Accessed January 9, 2018. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.