In this trial, treatments were given for 12 months. Note the decreasing slope of the MRD levels until Cycle 12 (end of treatment), then the positive slope of MRD levels up to 24 months after treatment. Also note the depth of response with V+O compared to Chl+O, but similar slope profiles (MRD increases when treatment stops).
The horizontal red line is U-MRD4
(<1 cell in 10,000). The lowest level is U-MRD6 (<1 cell in 1,000,000). (Sometimes we see these as percentages, where U-MRD4 is 0.01% - here it is shown in absolute terms, 0.0001.)
I guess I'm a little disappointed in the way the CLL is coming back after treatment is stopped. Even after reaching very low UMRD at 12 mos the line is almost back to MRD positive at only 24 mos . It doesn't seem to me that would indicate the kind of treatment free remissions that patients who reached UMRD after FCR were getting. Better not throw that FCR in the trash just yet.
"Assessment of minimal residual disease 18 months after end of treatment showed that 47.2% of patients in the VenG arm had undetectable (u) uMRD ( < 10−4), 13% had low (L)-MRD (≥ 10−4 and < 10−2) and 7.9% high (H)-MRD (≥ 10−2), compared to 7.4% uMRD, 17.1% L-MRD, 26.9% H-MRD in the ClbG arm. "
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