MRD Testing May Improve CAR-T Prognosis for Follicular Lymphoma

Measurable residual disease (MRD) assessment using circulating tumor (ct)DNA may offer improved prognostic information for patients receiving chimeric antigen receptor T-cell (CAR-T) therapy for follicular lymphoma. This finding was presented at the American Society of Clinical Oncology (ASCO) annual meeting.

The study analyzed data from 98 patients with relapsed or refractory follicular lymphoma who received CAR-T therapy. Researchers focused on ctDNA levels measured at various time points post-infusion, including 30 days, 90 days, and 6 months. The goal was to determine if these ctDNA measurements could predict treatment outcomes.

Results indicated that ctDNA-based MRD status at 30 and 90 days post-infusion was significantly associated with progression-free survival (PFS) and overall survival (OS). Specifically, patients who achieved ctDNA negativity by 90 days demonstrated a markedly better PFS compared to those who remained ctDNA positive. This suggests that early detection of residual disease through ctDNA could allow for more precise prognostication.

Furthermore, the study explored the utility of ctDNA dynamics, such as the rate of decline in ctDNA levels, as a predictive marker. The findings suggest that ctDNA assessment could potentially refine risk stratification for patients undergoing CAR-T therapy, enabling more personalized treatment strategies and follow-up plans. Further validation in larger, prospective trials is recommended to fully integrate this method into clinical practice.