MRD - Flow test compared to clonoSEQ

[JDG45]

I just got this result after a year of Acalabrutinib and Venetoclax on the Majic trial.

I'm currently waiting for the clonoSEQ MRD6 results. Below are the FLOW test results. Are they comparable. If so, I have a long long way to go for MRD6.

Bone marrow, flow cytometric immunophenotyping:

1. A CD5-positive, kappa light chain-restricted B-cell population is detected. MRD = 0.39%.

2 A CD5-positive, light chain-indeterminate B-cell population is detected. MRD = 0.034%.

This note was attached to the results:

This CLL MRD assay is validated to a sensitivity level of 0.002%.

Previous therapy targeting cell surface antigen(s) can interfere with this assay's performance.

Is this significant?

Thanks

JDG45

[e_yu]

I am in the same trial but on the V+O side, I believe the trial will use clonoSEQ MRD6 result for decision making since that's more accurate, it will only use FLOW test result if clonoSEQ fails to get something valid.

That said, based on other posts from patients in the same trial, I see no one on the A+V side reached uMRD after one year, my guess is A+V just needs more time since A is not as fast acting as O.

[JDG45 in reply to e_yu]

I guess the FLOW test was part of the Majic protocal at cycle 15. I did ask ask for a FLOW test back in January.

The clonoSEQ test I had during the screening in April said the MRD would be 20ppm (1.9 cells out of 84,795).

[SeymourB in reply to JDG45]

JDG45 -

The initial ClonoSEQ test is called an ID test, and serves to identify the dominant clones. It doesn't need to sequence as many cells.

Subsequent tests will sequence more than a million and as many as 2 or 3 million.

=seymour=

[Wonderwoman23]

Hello JDG45,I am also in the trial on the AV arm. Although I responded very well and achieved almost 10 -5 in the marrow, I have not achieved the 10-6 in the marrow or blood that is desired in the study. I will be on the AV for another year now. Hopefully, this 2nd year will get me there. I had so many emotions surrounding this and was very disappointed. However, I am grateful that the med combination is working , and my body is responding. I agree with e_you, that the AV combo may work slower. My doctor If you look under my profile you will find my posts and everyone's kind and informative responses 🙂. I hope they bring you the comfort and enlightenment about the study and results as they did for me.

Blessings,

Wonderwoman

[JDG45 in reply to Wonderwoman23]

WW23: My May clonoSEQ test showed 0.4% B cells. I'm kind of disappointed but look at it this way. It came down from 97% so that is a reduction of 240X. Not too bad. Taking the targeted meds for another 40 weeks is not a big deal but feel good about beating down those cells a lot more for a longer remission. How good do I f feel? I'm riding the Pan Mass Challenge on Aug 3 and 4 from Wellesley to Provencetown. That's 165 miles in 2 days and raising funds which will go to Dana Farber, Boston Children's Hospital and the Jimmy Fund for research and to financially help those little ones with cancer. By the way not too long ago those funds went to Dr. David's research team. They were key in getting the MAJIC trial going. I know they are working on treatments for when I am at the next PFS.

[Wonderwoman23 in reply to JDG45]

Love this !! Thank you for the inspiration !! I hope you continue to feel well and thank you for your contributions that help the little ones 😊