In recent years, with the widespread use of next-generation sequencing (NGS), the ability to detect minimal residual disease (MRD) in hematological malignancies, especially leukemia and multiple myeloma, has improved more and more influence on the treatment mode. In lymphoma, the use of ctDNA for lymphoma MRD monitoring has great application value in lymphoma MRD monitoring due to the technical advantages of convenient sampling and sensitivity, but there is still a lack of evidence from large samples to support its clinical application. As a leading immunomic sequencing company in China, Pan-Gene Medicine has cooperated to organize the first largest sample size “Multi-center research project on DLBCL MRD monitoring with ctDNA-IgNGS” (MeDIG Study: MRD detection of DLBCL by IG HTS). The research is led by Professor Qiu Lugui from Tianjin Institute of Hematology, and experts in the field of hematology and tumor from more than ten hospitals across the country will participate in the research. During the 17th National Academic Conference on Hematology of the Chinese Medical Association in 2022, Pan-Casual Medicine will hold a satellite meeting on the theme of “Ig/TCR NGS in the clinical application of hematological tumors”, and will also hold the launch meeting of the research project offline. . Professor Qiu Lugui from Tianjin Institute of Hematology was invited as the chairman of the meeting, Professor Huang Liang from Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology served as the chair, and Professor Liu Wei from Tianjin Institute of Hematology gave a wonderful special report.
Chairman’s opening remarks
Professor Qiu Lugui said in his speech:
The clinical evaluation of DLBCL is mainly through imaging, but imaging has certain limitations, unable to detect deep remission and early monitoring of recurrence. Most DLBCL are mainly solid masses, and currently in In solid tumors, more and more evidence-based evidence has been obtained using ctDNA as a means of efficacy evaluation and recurrence monitoring. We hope that this research project can be carried out smoothly with the support of peers, and we can obtain our own evidence-based evidence as soon as possible. MRD monitoring technology can be pushed to clinical application.
Professor Liu Xiao gave an opening speech:
Professor Liu Xiao, founder of pan-causative medicine, also mentioned in his speech that “Based on pan-causative medicine’s research and development experience in lymphocyte receptor gene detection technology in the past ten years, I believe that under the leadership of Prof. Qiu Lugui The following research project can provide real-world clinical evidence for clinical decision-making and clinical intervention based on NGS-MRD detection with lymphocyte receptor as a marker.”
Special report: Clinical application of Ig/TCR NGS in hematological tumors
Professor Liu Wei then introduced the application of Ig/TCR NGS technology in the clinical differential diagnosis of hematological tumors and MRD monitoring. The monoclonal rearrangement of the lymphocyte receptor gene is the main feature of lymphoma cells and can be used to assist in the identification of monoclonal and polyclonal lymphocyte proliferation, as well as lymphomas that cannot be diagnosed by IHC. important supplement. And IgNGS detection can obtain clear clone sequence information, can accurately determine the mutation frequency of IGHV, provide risk stratification guidance for CLL patients, and can conduct follow-up MRD tracking.
About the application of Ig/TCR NGS to monitor MRD Prof. Wei Liu emphasized the clinical significance of the sensitivity advantage of NGS in detecting MRD: high-sensitivity MRD detection can further subdivide the degree of remission of patients, Screen patients with high and deep remission (eg, MRD less than 10-6) and further risk stratify patients. In addition, it also emphasizes the need for persistent monitoring of MRD. Changes in MRD kinetics are closely related to PFS. Data from the TOURMALINE-MM4 study showed that non-transplant NDMM patients had significantly lower PFS than MRD-negative patients after induction therapy, but in MRD-positive patients The PFS of MRD-negative-to-positive patients was significantly better than that of MRD-positive patients (P=0.006), indicating that long-term and regular MRD monitoring is very necessary. The use of ctDNA for lymphoma MRD monitoring has the technical advantages of convenient sampling and high sensitivity. A large number of studies have shown that ctDNA monitoring can detect the recurrence trend earlier than imaging, and it has become a potential new strategy for the management of lymphoma patients. However, there is still a lack of evidence to support ctDNA-based MRD monitoring in clinical practice.
“Multi-center clinical study of DLBCL MRD monitoring with ctDNA-IgNGS” kick-off meeting
In order to use plasma ct-DNA IgNGS to evaluate the application value of MRD in the whole process of lymphoma treatment and to establish the MRD monitoring standard of ctDNA-IgNGS technology in lymphoma patients, it was established by Tianjin Institute of Hematology. Led by Professor Qiu Lugui, the country’s first “multi-center research project on DLBCL MRD monitoring with ctDNA-IgNGS” officially launched by the Pan-Cause Medicine Cooperation Organization.
Conference Summary
Finally, Prof. Huang Liang made a summary of the meeting: The high sensitivity and continuous sampling advantages of ctDNA-based Ig/TCR NGS detection are important methods for long-term clinical monitoring, and it is not limited toIn peripheral blood, sensitive detection can also be performed in cerebrospinal fluid and other body fluid samples, and there are still many clinical application scenarios worth exploring.
