AMPlifying the MRD Conversation

As the spotlight on the Association for Molecular Pathology (AMP) annual meeting and expo fades, The Pathologist team heads back to the office with brains full of knowledge and hearts full of gratitude. I’d like to take a moment to thank everyone that connected with us in Vancouver, both in conversation of further content and in praise of our magazine. It’s truly an honor to have such a wonderful community surrounding us and we’re energized to continue providing you with the latest in pathology news and views.

With this in mind, I’m taken back to day one of AMP 2024 and a Fireside Chat focused on bridging the gaps in implementing minimal residual disease (MRD) testing in clinical practice for oncology. This collaborative session sought to educate fellow laboratory professionals on clinical implementation, the current landscape, and future directions of MRD testing.

The talk was very insightful, with panelists from pharma, education, and the clinical lab sharing their expertise and experiences of MRD diagnostics. Christina Lockwood opened the discussion, setting the scene with her definition of MRD as “the sub-clinical presence of a cancer-associated biomarker indicating a high risk of recurrence that cannot be detected by standard imaging techniques.”

Here are some of the key points that emerged from the session:

• With circulating tumor (ct) DNA testing being applicable to both early- and advanced-stage disease, Lockwood advocated the acceleration of liquid biopsy assay developments in order to improve outcomes for cancer patients.
• From digital PCR to NGS, there are many tests in use for MRD – all with different considerations and challenges. Kelli Bramlett noted that deciding on which test to use can leave a lot of clinicians feeling frazzled. There is an urgent need for better guidance.
• Krupa Paranjpe noted that, from bench to bedside, there’s an average time of five years for patients receiving standard care. An oncologist may prioritize getting the care to their patient as soon as possible over focusing on the best test to use at the offset. Implementing testing standards across the board will improve diagnostics and, most importantly, care for patients.
• To overcome challenges and widely introduce new technologies for MRD testing, Ramin Dowlati explained that there must be proof of better outcomes for the patients. This could be made easier through standardized guidelines, allowing for harmonization and collaboration between companies and clinicians.
• In response to Dowlati’s comments, Jennifer Dickey cited a great need for a move towards standardization and establishing communal referencing. Only by defining the clinically relevant MRD levels will laboratories be able to optimize testing..

Hungry for more insights? Watch this space for full interviews with some of the panellists!

Do you have anything to add to the MRD conversation? Maybe you’re working closely on this diagnostic challenge in the lab. Get in touch and share your experiences with us and The Pathologist community: [email protected]