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EHA 2025 | Integrating MRD into routine practice for B-cell malignancies: challenges that remain
Chan Cheah, MBBS, FRACP, FRCPA, DMSc, Linear Clinical Research and Sir Charles Gairdner Hospital, Perth, Australia, discusses challenges that remain in integrating measurable residual disease (MRD) into routine practice for B-cell malignancies. Dr Cheah highlights standardization, funding, and capacity issues, and then goes on to discuss the value of MRD. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
So look, MRD is increasingly being utilised in the treatment of patients with B-cell malignancies. Our limitation is that primarily they’re research tools and they’re not being routinely deployed as standard of care in most institutions through a variety of standardization, funding and capacity issues. So I think as a field we really need to work on getting all those things sorted out so we can start to implement MRD more routinely in clinical practice and continue to design well-considered clinical trials to allow escalation and de-escalation based on MRD results...
So look, MRD is increasingly being utilised in the treatment of patients with B-cell malignancies. Our limitation is that primarily they’re research tools and they’re not being routinely deployed as standard of care in most institutions through a variety of standardization, funding and capacity issues. So I think as a field we really need to work on getting all those things sorted out so we can start to implement MRD more routinely in clinical practice and continue to design well-considered clinical trials to allow escalation and de-escalation based on MRD results. I think it’s important because as we’re getting more and more effective therapies we are learning that patients with a complete response on PET are not necessarily destined to be guaranteed to avoid relapse and so the combination of PET and MRD can be used to better stratify patient populations after treatment for different approaches and in fact can allow us to de-escalate as well and avoid toxicity in patients who don’t need it. So we’re starting to see more of those studies come through and increasingly as we’re designing these trials it’s of critical importance to continue to have MRD as a key exploratory endpoint and we’re now starting to see it increasingly as a primary endpoint on studies.
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