Table 2. Harmonized methods for residual disease detection using ERIC-harmonized approaches.
Application | Assay | Advantages | Disadvantages |
---|---|---|---|
Trials aiming for disease control rather than eradication, e.g. continuous BCR pathway inhibition | Clonality assessment | •Relatively inexpensive and simple | •Requires capacity to reflex to full MRD assay if CLL cells <1.0% and/or B cells polyclonal |
Trials focusing on achieving <0.010% MRD, i.e. with broadly similar responses rates to FCR, | 4-color 4-tube | •Published outcome data. •Does not require pretreatment phenotype for typical CLL | •Limit of detection >0.0050% •More material required to achieve higher detection limits |
requiring an MRD assessment that is published and has been used in previous clinical trials | 6-color 2-tube | •Harmonized with 4-color assay •Does not require pretreatment phenotype for typical CLL | •Intermediate LOD/LOQ •Intermediate amount of material required to achieve higher detection limits |
Trials aiming for significant improvements in disease depletion compared with FCR | 6-color core panel for ⩾6-color assays 1-tube | •Permits flexibility for individual laboratory requirements •LOD 0.0010% (10-5), LOQ 0.0025% •Allows simultaneous analysis of additional markers | •Knowledge of pretreatment phenotype preferable |
High throughput sequencing | •LOD 0.00010% (10-6) •Objective analysis, does not necessarily require expert interpretation | •Further development work on standardization of the quantification |
Abbreviations: LOD, limit of detection; LOQ, limit of quantification.