Mayo Clinic Laboratory and pathology research roundup: January 25
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The research roundup provides an overview of the past week’s research from Mayo Clinic Laboratories consultants, including featured abstracts and a complete list of published studies and reviews.
Featured Abstract
Measurable residual disease does not preclude prolonged progression-free survival in CLL treated with ibrutinib.
E1912 was a randomized phase 3 trial comparing indefinite ibrutinib plus 6 cycles of rituximab (IR) to 6 cycles of fludarabine, cyclophosphamide, and rituximab (FCR) in untreated younger patients with CLL. We describe measurable residual disease (MRD) levels in E1912 over time and correlate them with clinical outcome. Undetectable MRD rates (<1 CLL cell per 104 leukocytes) were 29.1%, 30.3%, 23.4%, and 8.6% at 3, 12, 24, and 36 months for FCR, and significantly lower at 7.9%, 4.2%, and 3.7% at 12, 24, and 36 months for IR, respectively. Undetectable MRD at 3, 12, 24, and 36 months was associated with longer progression-free survival (PFS) in the FCR arm, with hazard ratios (MRD detectable/MRD undetectable) of 4.29 (95% confidence interval [CI], 1.89-9.71), 3.91 (95% CI, 1.39-11.03), 14.12 (95% CI, 1.78-111.73), and not estimable (no events among those with undetectable MRD), respectively. In the IR arm, patients with detectable MRD did not have significantly worse PFS compared with those in whom MRD was undetectable; however, PFS was longer in those with MRD levels <10-1 than in those with MRD levels above this threshold. Our observations provide additional support for the use of MRD as a surrogate end point for PFS in patients receiving FCR. In patients on indefinite ibrutinib-based therapy, PFS did not differ significantly by undetectable MRD status, whereas those with MRD <10-1 tended to have longer PFS, although continuation of ibrutinib would very likely be necessary to maintain treatment efficacy.
Published to PubMed This Week
- The digital transformation of Hepatology: The patient is logged In.
Hepatology - Heterogeneous delivery across the blood-brain barrier limits the efficacy of an EGFR-targeting antibody drug conjugate in glioblastoma.
Neuro-Oncology - European LeukemiaNet-defined primary refractory acute myeloid leukemia: the value of allogeneic hematopoietic stem cell transplant and overall response.
Blood Cancer Journal - Histologic and proteomic remodeling of the pulmonary veins and arteries in a porcine model of chronic pulmonary venous hypertension.
Cardiovascular Research - Impact of the Coronavirus disease 2019 (COVID-19) vaccine on asymptomatic infection among patients undergoing preprocedural COVID-19 molecular screening.
Clinical of Infectious Disease - Comparison of response to definitive radiotherapy for localized prostate cancer in back and white men: A meta-analysis.
JAMA Network Open - Assessment of regional variability in COVID-19 outcomes among patients with cancer in the United States.
JAMA Network Open - Metabolic syndrome and acute respiratory distress syndrome in hospitalized patients with COVID-19.
JAMA Network Open - Clinical impact of the refit CKD-EPI 2021 creatinine-based eGFR equation.
Clinical Chemistry - Association between spinal stenosis and wild-type ATTR amyloidosis.
Amyloid
