Customised MRD solution for solid organ cancer

cancertrack - MRD is a customised panel that detects molecular residual disease (MRD) based on deep sequencing of the tumour tissue and blood.

About cancertrack - MRD

cancertrack - MRD is an advanced detection method which identifies even small amounts of residual disease (ctDNA) in the bloodstream and thus provides critical insights for decision-making regarding adjuvant chemotherapy and enables early detection of recurrence. cancertrack - MRD is a unique, ultrasensitive, dual approach molecular residual disease detection assay that uses tumour-informed as well as tumour-agnostic strategies.

Early detection of ctDNA in blood supports clinicians to assess if:

  • additional / adjuvant therapy is required.
  • tumour is responding to therapy.
  • cancer has returned after initial response.
  • existing cancer is progressing.

cancertrack - MRD is suitable for ...

... every patient who is under treatment for cancer.

... every patient who is in remission / a cancer survivor and needs monitoring.

... every patient who has been diagnosed with cancer, as an add-on to conventional biopsy and imaging.

cancertrack-MRD can be used in following situations:

MRD - result interpretation

  • MRD positive (MRD+)
    • Predicts benefit from adjuvant therapy (post curative intent surgery).
    • Predicts increased risk of disease recurrence.
  • MRD negative (MRD-)
    • Predicts no / limited benefit from adjuvant therapy in early stage cancers (post curative intent surgery).
    • Predicts low risk of disease recurrence.

  • Tumour-informed strategy
    • Baseline sequencing of tumour tissue to identify individual somatic alterations.
    • Subsequent tracking of these personalised somatic alteration in plasma for detecting molecular residual disease with custom designed assay.
    • Paired germline sequencing to confirm high frequency somatic variant (CHIP analysis).
    • Offers robust high-sensitivity detection of this personalised alteration with droplet digital PCR (ddPCR) based assay.
  • Tumour-agnostic strategy
    • Using tumour-agnostic approach to detect pre-existing as well as emerging resistance mutations.
    • Paired germline sequencing to rule out Clonal Hematopoiesis of Indeterminate Potential (CHIP).
    • Capturing of newly emerging tumour clones helps addressing tumour evolution and tumour heterogeneity.
    • Using tumour-agnostic ctDNA analysis to detect MRD by profiling pre-existing and/or new tumour clones.

cancertrack - MRD analyses

  • Tissue: baseline tumour sequencing by NGS - 395 genes, incl. TMB (tumour mutational burden) analysis - and paired tumour-genomic DNA analysis to exclude CHIP and germline variants.
  • Blood: additional 52 genes NGS based tumour-agnostic ctDNA profiling to identify new clones.
  • Blood: tracking of selected personalised mutations with ddPCR based assay at 0.01% Limit of Detection.

Tumour tissue and paired gDNA analysis
Tumour tissue is sequenced to identify and create a custom panel of selected personalised mutations.

Tumour-informed ctDNA assay
ddPCR is used to detect the presence of these selected personalised mutations.

Tumour-agnostic ctDNA assay
NGS based assay detects alterations in 52 actionable cancer genes in ctDNA.

cancertrack – MRD

Customised MRD solution for solid organ cancer – PDF-Download

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FAQ

Why is early detection of molecular dynamics of cancer critical?

The molecular evolution of the tumour, including tumour size and molecular diversification, is a continuous process that can progress at high speed. Therefore, early detection of recurrence or drug resistance is essential to keep the cancer under control.

What is the concrete advantage of MRD testing?

MRD analysis has demonstrated that some patients can avoid chemotherapy during adjuvant therapy. In a few countries, it has already been incorporated into the guidelines for colon cancer, and further investigations are ongoing for other types of cancer.

What is different compared to the "standard" ctDNA test?

The use of ddPCR increases the sensitivity for the detection of ctDNA tenfold, resulting in improved outcomes and safer decisions.

How does the recommended blood draw schedule look like?

Settings: Adjuvant setting | Time points: Within 8 weeks - post-surgery
Settings: End-of-treatment setting | Time points: At completion of all local and systemic treatment
Settings: Surveillance setting |Time points: Every 3 - 6 months thereafter

Sample collection & Turn Around Time (TAT)

Sample collection: 30 ml blood in tubes; one blood collection only, plasma will be stored for subsequent ddPCR analysis; FFPE tissue block with adequate tumour content (10%)
Turn Around Time (TAT): 3 - 8 weeks from receipt of the sample in the labortatory