Dr. Kasi on the Role of MRD Testing in CRC

Pashtoon M. Kasi, MD, MS, ​Assistant Professor of Internal Medicine, Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa, discusses the role of minimal residual disease (MRD) testing in colorectal cancer (CRC).

Patients with MRD have a small number of cancer cells left in the body following curative surgery, which “shed” tumor DNA that can be detected in circulating blood, Kasi explains. Notably, MRD is what is not visible on scans, which creates a challenge as well as an opportunity in terms of treatment selection.

As such, the field now has improved technologies that can detect MRD or circulating tumor DNA (ctDNA) in patients with ​noninvasive blood tests and we are learning how to use these assays by doing more studies and clinical trials. 

For example, ​data regarding Signatera, a personalized, tumor-informed assay that can detect ctDNA and MRD in patients, were presented during the 2020 ASCO Virtual Scientific Program. When tumor-informed assays are sent for genetic profiling, individualized mutations are selected​ for analysis, which can optimize the yield, sensitivity and confidence of ​MRD assessment, Kasi concludes.