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Detectable residual disease (MRD) status is recognized as an important clinical endpoint in chronic lymphocytic leukemia (CLL) and remains relevant to patient outcomes in the era of targeted therapy
leukemia
This study reports the characteristics of MRD in 290 patients with CLL receiving rituximab in combination with continuous ibrutinib and assessed its association with progression-free survival
The E1912 study is a randomized phase 3 trial comparing indefinite ibrutinib + 6 cycles of rituximab (IR) with 6 cycles of fludarabine, Efficacy of cyclophosphamide and rituximab (FCR)
Detection of MRD status at different time points in FCR group and IR group
Detection of MRD status at different time points in FCR group and IR groupThe undetectable rates of MRD at 3 months, 12 months, 24 months and 36 months in the FCR group were 29.
The undetectable rates of MRD at 3 months, 12 months, 24 months and 36 months in the FCR group were 29.
Survival of patients in the FCR group by MRD status
Survival of patients in the FCR group by MRD statusIn the FCR arm, undetectable MRD at 3, 12, 24, and 36 months was associated with longer progression-free survival (PFS) , hazard ratio (MRD detectable/undetectable) ) were 4.
In the FCR group, 3 months, 12 months, 24 months and 36 months of undetectable MRD and longer progression-free survival (PFS) related to the FCR group, 3 months and 12 months , undetectable MRD at 24 months and 36 months associated with longer progression-free survival (PFS)
Survival of patients in the IR group by MRD status
Survival of patients in the IR group by MRD statusIn the IR group, patients with detected MRD did not have significantly worse PFS compared with patients without MRD; however, patients with MRD levels <10-1 had PFS compared with patients with MRD levels above this threshold significantly longer
PFS was not significantly worse in patients with detected MRD
Taken together, the results of this study support the use of MRD as a surrogate endpoint for PFS in patients treated with FCR
The findings support the use of MRD as a surrogate endpoint for PFS in patients treated with FCR
Original source:
Xin Victoria Wang, et al.
Measurable residual disease does not preclude prolonged progression-free survival in CLL treated with ibrutinib
