In a systematic review and meta-analysis of 719 patients with mantle cell lymphoma (MCL) who were treated in 10 clinical trials conducted between 2002 and 2020, patients who were MRD-positive at a sensitivity level of 10-4 after induction or consolidation treatment fared significantly worse on both progression-free survival (PFS) and overall survival (OS) measures compared with those who were MRD-negative. The study, by researchers in Beijing, China, appears in the January 2021 issue of the Journal of Cancer.
Six of the included trials were conducted in Europe, three in North America, and one in South America. Patients, whose median age ranged from 55 to 73, were treated with a wide variety of induction, consolidation, and maintenance regimens. Six trials enrolled ASCT-eligible patients. In nine trials MRD was assessed by polymerase chain reaction (PCR) and in one by both PCR and flow cytometry. MRD assessment was performed at varying intervals and times, including post–induction treatment, post–consolidation treatment, post–ASCT, and during maintenance therapy.
Hazard ratios (HRs) for shorter PFS and OS were consistently elevated for MRD-positive patients (post induction HR of 1.44 for shorter PFS, 1.3 for shorter OS; post consolidation HR of 1.84 for shorter PFS, 2.38 for shorter OS).
The researchers concluded that “MRD-based treatment strategies should be further explored in clinical trials and real-world practice” for patients with MCL.
- Zhou Y, Chen H, Tao Y, Zhong Q, Shi Y. Minimal Residual Disease and Survival Outcomes in Patients with Mantle Cell Lymphoma: a systematic review and meta-analysis. J Cancer. 2021;12(2):553-561. Published online 2021 Jan 1. doi:10.7150/jca.51959