Dr. Goy on the Importance of MRD Status in Patients With MCL

Andre Goy, MD, MS, chief, Division of Lymphoma, chairman and director, John Theurer Cancer Center, discusses the importance of achieving minimal residual disease (MRD) negativity in mantle cell lymphoma (MCL).

MRD negativity translates into improved outcomes, regardless of the presentation, complete remission or partial remission status, Mantle Cell Lymphoma International Prognostic Index, age, and regimen. The question is, “Can physicians change MRD positivity to MRD negativity?” High-dose therapy and transplant may improve outcomes, but the data from the NORDIC regimen show that the outcomes prior to transplant are worse for patients who are MRD positive, Goy says.

The regimen looked at rituximab (Rituxan) preemptively in patients who converted from MRD-negative to MRD-positive status. Though the vast majority of patients achieved MRD negativity, most of them relapsed. Although checkpoint inhibitors have not been utilized as monotherapy in MCL, combining other therapies like venetoclax (Venclexta) and immunotherapy may be a way to address MRD status, states Goy.