Yesterday we presented the results of a combined experience of MRD analysis and PET results in a Phase III trial sponsored by Fondazione Italiana Linfomi on first-line follicular lymphoma. Patients were randomized to receive treatment with either R-CHOP or R-bendamustine according to physician choice and then were randomized to receive a maintenance modulated on the basis of MRD. What we show is that both PET response at the end of induction and MRD response at the end of induction measured both on bone marrow or peripheral blood, are independent prognosticators for PFS in follicular lymphoma...
Yesterday we presented the results of a combined experience of MRD analysis and PET results in a Phase III trial sponsored by Fondazione Italiana Linfomi on first-line follicular lymphoma. Patients were randomized to receive treatment with either R-CHOP or R-bendamustine according to physician choice and then were randomized to receive a maintenance modulated on the basis of MRD. What we show is that both PET response at the end of induction and MRD response at the end of induction measured both on bone marrow or peripheral blood, are independent prognosticators for PFS in follicular lymphoma. They also independently predict POD24 for PET positive patients and MRD positive patients. And finally, we studied the combination of both markers, and we found that if at the end of the induction, the prognostic value of PET prevails, then if we continue monitoring over time every six months until month 36 after the achievement of complete molecular remission, if we monitor MRD, a positivity of any MRD samples in this window without treatment or under rituximab maintenance is predictive for an excess risk of progression-free survival. So, for example, if you are MRD positive in peripheral blood at 36 months after the achievement of complete molecular remission, you have a five-fold risk of relapse.