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An Expert Breaks Down the Meaning of MRD Testing in Cancer Care

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Key Takeaways

  • MRD signifies remaining cancer cells post-treatment, with interpretations varying by cancer type.
  • MRD testing methods include flow cytometry and genomic tests, detecting residual cancer cells.
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Dr. Christopher R. Flowers delved into the meaning of MRD, discussing different ways that it may be tested for in patients with various types of cancer.

The meaning of minimal residual disease (MRD) can be interpreted in different ways across different indications of cancer, according to Dr. Christopher R. Flowers, who added that there's not one single interpretation; however, the most widely accepted meaning is when a patient who has completed treatment for their cancer has cancer cells that remain in a patient’s body after undergoing treatment.

"[A positive] result can mean that there is some likelihood of the cancer coming back at a later date related to the [outcome of the] test," Flowers explained in an interview with CURE.

In the interview, Flowers explained the meaning of MRD and MRD testing for patients, discussing different ways that MRD may be tested for across various types of cancer. Flowers works in the Department of Lymphoma — Myeloma, Division of Cancer Medicine, at the University of Texas MD Anderson Cancer Center, in Houston.

Glossary:

Circulating cells: refers to white blood cells or circulating tumor cells.

CT scan: a noninvasive imaging procedure that uses X-rays and a computer to create detailed pictures of the inside of the body.

Flow cytometry: a lab test that uses lasers to analyze the physical and chemical properties of cells or particles.

Minimal residual disease (MRD): a medical term used to describe the small number of cancer cells that remain in the body after treatment.

Transcript:

This can mean different things for different cancers, and so there's not one single interpretation for that. Oftentimes, what it means is that for a patient who has undergone a typical evaluation after completion of their treatment — like with CT scans or with typical blood tests — to know whether there's any evidence of disease, and all of those tests come back negative, showing that there's no detectable disease, by traditional means, and then to have some form of a blood-based MRD test. Now, for different diseases, that can be a different kind of test, so that could be things like flow cytometry that is able to detect, to a very small level, circulating cells from cancer. It could be a test like a genomic or genetic test, where it can detect evidence of the genes that are associated with that cancer even though you can't detect levels of that cancer itself that are circulating in the bloodstream… 

There is the possibility in some settings, of that being a false positive test, so that's something that's also important to keep in mind; the test could come back positive, but there really is not detectable cancer in that setting. That's much less common for these kinds of tests, but that still can occur. For different cancers, the detection of MRD means different things. For some cancers that might be more rapidly growing, that may be a sign that the cancer is coming back in a relatively short period of time. For other kinds of cancers that may be slower growing, it may mean that there's a need for continuing monitoring over time.

Transcript was edited for clarity and conciseness.

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