Measurable Residual Disease (MRD) Testing

What is Measurable Residual Disease (MRD)?

Measurable Residual Disease (MRD), also referred to as minimal residual disease, represents the small number of malignant cells that persist after therapy but remain undetectable by conventional methods such as microscopy or imaging.
NGS-based MRD testing provides ultra-sensitive molecular detection of residual disease for treatment response assessment, early molecular relapse monitoring, risk stratification, therapy guidance, and longitudinal disease surveillance across hematological malignancies and solid tumors.
MRD positivity may precede clinical or radiological relapse by weeks to months, supporting earlier therapeutic intervention and informed clinical decision-making

Key Features of Minimal Residual Disease Testing

Feature Description
High-Sensitivity Detection Detects residual malignant cells beyond conventional diagnostic thresholds.
NGS-Based MRD Assessment Identifies clinically relevant SNVs, indels, CNVs, gene fusions, and other genomic biomarkers with high analytical sensitivity.
Molecular Response Monitoring Enables longitudinal tracking of treatment response and disease burden.
Early Molecular Relapse Detection Detects molecular relapse prior to clinical or radiological progression.
Genomic Alteration Tracking Monitors disease-associated genomic alterations and fusion transcripts.
ctDNA-Based MRD Assessment Enables non-invasive molecular monitoring in solid tumors using liquid biopsy and circulating tumor DNA (ctDNA).
Baseline & Longitudinal Monitoring Compares baseline and follow-up molecular profiles for serial MRD assessment.
Post-Transplant Surveillance Supports pre- and post-hematopoietic stem cell transplant monitoring.
Prognostic & Risk Assessment Provides prognostic insights for relapse risk assessment and therapy decision-making.

Clinical Applications of NGS Based MRD Testing

  • Treatment response monitoring across hematological malignancies and solid tumors.
  • Detection of molecular relapse prior to clinical or radiological progression.
  • Post-induction, consolidation, and maintenance therapy surveillance.
  • Pre- and post-hematopoietic stem cell transplant MRD assessment.
  • Therapy stratification based on MRD status.
  • Monitoring of disease-associated genomic alterations, including fusion transcripts.
  • Non-invasive ctDNA-based MRD assessment in solid tumors.
  • Prognostic risk assessment and recurrence monitoring during follow-up care.

Specifications

  • Indications: Hematological malignancies and solid tumors for MRD assessment, treatment response monitoring, and molecular relapse detection.
  • Methodology: Next-Generation Sequencing (NGS)-based molecular profiling with baseline and longitudinal follow-up monitoring for MRD assessment.
  • Sample Type: Peripheral blood, bone marrow aspirate, plasma (ctDNA), fresh tissue, and FFPE tissue blocks.
  • Gene Coverage : SNVs, InDels, CNVs, Gene Fusions/Rearrangements, MSI, TMB, and HRD-associated markers.

MRD Tests Offered by MedGenome

Key Highlights of Molecular Testing in MRD Testing

Ultra-Sensitive Molecular Detection

Detects residual malignant cells at very low molecular levels beyond conventional diagnostic methods.

Comprehensive Genomic Coverage

Extensive coverage of clinically relevant SNVs, InDels, CNVs, gene fusions, MSI, TMB, and HRD-associated genomic signatures.

Longitudinal MRD Monitoring

Supports baseline and serial molecular monitoring for treatment response assessment and early molecular relapse detection.

What is Measurable Residual Disease (MRD)?

After cancer treatment, a very small number of cancer cells may remain in the body. These cells may be too few to be detected through routine tests or under a microscope. This is called Measurable Residual Disease (MRD).
Even a small number of remaining cancer cells may increase the risk of the disease returning if not monitored carefully.

MedGenome scientist conducting genetic testing and DNA test services in India

Why is MRD Testing Important?

MRD testing helps doctors:

  • Understand how well treatment is working
  • Detect early signs of disease recurrence
  • Assess the risk of relapse
  • Guide treatment and follow-up decisions
  • Monitor patients after stem cell or bone marrow transplant.

An MRD-negative result generally indicates a deeper treatment response, while an MRD-positive result may require closer monitoring or additional treatment evaluation.

How is MRD Testing Performed?

Who May Benefit from MRD Testing?

MedGenome clinician reviewing patient records to support genetic testing and DNA test in India

When is MRD Testing Recommended?

MRD testing may be advised:

  • After initial treatment
  • During or after consolidation therapy
  • Before or after stem cell transplant
  • During maintenance therapy
  • During follow-up monitoring visits

The timing of testing depends on the type of cancer and treatment plan.

What Do MRD Results Mean?

FAQs

  • How often should MRD testing be done?

    The frequency of MRD testing depends on the type of cancer, treatment plan, and clinical condition of the patient. MRD assessment is commonly performed after induction therapy, during consolidation, before or after stem cell transplantation, and during follow-up monitoring. Your oncologist will determine the appropriate testing schedule based on disease-specific guidelines and treatment response.

  • Which cancers require MRD testing?

    MRD testing is most used in haematological malignancies such as Acute Lymphoblastic Leukaemia (ALL), Acute Myeloid Leukaemia (AML), Chronic Myeloid Leukaemia (CML), Multiple Myeloma, and certain lymphomas. MRD monitoring is also increasingly being used in select solid tumours using liquid biopsy and ctDNA-based approaches to assess treatment response and detect molecular relapse.

  • Can MRD predict relapse?

    Yes. MRD positivity may indicate the presence of residual cancer cells that remain after treatment and can increase the risk of disease relapse. In many cancers, MRD detection can identify molecular relapse weeks to months before clinical symptoms or conventional diagnostic methods detect recurrence, enabling earlier clinical intervention and personalized treatment decisions.

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