Why is MRD Testing Like clonoSEQ Important?

One of the most precise methods of detecting blood cancer cells in the body is minimal residual disease (MRD) testing. The type of MRD test known as next-generation DNA sequencing, such as Adaptive’s clonoSEQ test, is particularly effective in detecting the number of cancer cells left after treatment. 

What is MRD Testing? 

Minimal residual disease (MRD) testing helps find the smallest number of cancer cells that may remain in a patient's body following treatment, or during remission periods. Its sensitivity is so high that it can identify remaining cancer cells that often go undetected by conventional clinical or laboratory tests. This detection ability gives healthcare professionals highly accurate insight into the depth of a patient's response to treatment and offers predictions about the possibility of their cancer coming back. 

MRD tests target markers specific to cancer cells. By identifying and counting these markers in the blood or bone marrow, MRD testing can determine the presence or absence of remaining cancer cells, otherwise known as residual disease. 

Typically, MRD test results are presented as a ratio or percentage, which shows the number of residual cells relative to a given number of standard cells. A lower MRD percentage indicates better disease control and a decreased likelihood of relapse, whereas a higher MRD percentage suggests a higher potential for disease recurrence. If cancer cells are not detected, it is called MRD negative or undetectable MRD (uMRD). 

Learn more about monitoring MRD from the experts at HealthTree University:

Watch the MRD Testing Unit

Which MRD Test Do I Need? 

MRD detection in blood cancers can be completed through several methods, including flow cytometry, polymerase chain reaction (PCR), and next-generation DNA sequencing (NGS). Next-generation DNA sequencing has been found to have a more accurate response than other types of MRD testing, like flow cytometry, and it is available in some blood cancers, such as multiple myeloma, chronic lymphocytic leukemia (CLL), and diffuse large B-cell lymphoma (DLBCL).

Does My Insurance Cover MRD Testing? 

MRD tests like clonoSEQ are covered by Medicare and other major insurance providers for myeloma, DLBCL, CLL, and ALL. Adaptive’s patient support program states that 90% of patients pay $0 for clonoSEQ. If you have questions about clonoSEQ, contact their patient support program by clicking here.

What Does Undetectable MRD or MRD Negativity Mean? 

It's important to differentiate MRD negativity from a definitive cure. Although the test might not detect any cancer cells to a certain extent, small quantities below the test's detection threshold might still exist, posing a risk for potential relapse. 

Nonetheless, those who achieve MRD negativity often have an encouraging prognosis, frequently remaining in remission for extended periods of time. 

In conclusion, minimal residual disease (MRD) tests accurately assess the amount of cancer cells left in the body after treatment. This information can help medical teams and patients make informed decisions about the treatment plan. 

Sources

• MRD Negativity Outcomes
• Minimal Residual Disease (MRD)
• ClonoSEQ
• Comparison of Next-Generation Flow Cytometry (NGF) and Next-Generation Sequencing (NGS) in the Assessment of Minimal Residual Disease