SOHO 2025 | Advances in MRD-guided therapy in AML & strategies being explored to eradicate MRD

We’re getting better at detecting measurable residual disease in patients with acute myeloid leukemia. We’re getting better because people are getting more skilled at doing flow cytometric analyses. And now we also have next generation sequencing platforms that are more highly sensitive than the ones that were previously. We have RT-PCR assays. And I think it’s clear that not having MRD is better than having MRD. You know, the question is, what is the way to get rid of that MRD? Or is there, you know, you can say that it’s better not to have MRD, but then it’s a leap to say what you should do to get rid of the MRD. There are finally some clinical trials that have started to try to assess whether MRD can be eradicated either before a transplant or at the time of an MRD relapse. Some of those therapies, some of those trials are using targeted therapies like, honestly, like revumenib to target MRD in patients with KMT2A rearrangements. We have a clinical trial at Sloan Kettering, which I’m very excited about, which is looking at giving patients a cycle of azacitidine and venetoclax. So patients who have gotten intensive chemotherapy are MRD positive after their intensive chemotherapy. They’re due to go to transplant. We have a trial testing to see if you give one cycle of aza-ven, whether that might put those patients into an MRD negative state before the transplant. So we’re really excited about this. It’s an area that is important and an area that, again, I think we’re going to be seeing a lot more research come out about it over the next few years.

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