Precise MRD uses which approach to select variants for monitoring?

Precise MRD uses which approach to select variants for monitoring?

• A. Tumor-informed variant selection
• B. Random variant selection
• C. Single mutation only
• D. RNA-based markers

Answer: (A)

Focusing MRD monitoring on the patient’s actual tumor mutations gives the most precise tracking of residual cancer. In a tumor-informed approach, the tumor tissue is sequenced to identify somatic mutations unique to that individual’s cancer. Those exact mutations are then used to design a personalized assay that looks for the same mutations in a blood sample or other body fluid. Because you are monitoring mutations confirmed to be present in the tumor, this method is highly sensitive and specific for detecting very small amounts of tumor DNA, and it can pick up subclones that might be missed by a generic panel. Choosing random mutations would likely miss the true tumor profile and introduce noise. Relying on a single mutation risks false negatives if that clone decreases or isn’t representative of all residual disease. RNA-based markers can be informative in some settings, but DNA mutation tracking in cell-free DNA tends to be more stable and specific for MRD monitoring.

Focusing MRD monitoring on the patient’s actual tumor mutations gives the most precise tracking of residual cancer. In a tumor-informed approach, the tumor tissue is sequenced to identify somatic mutations unique to that individual’s cancer. Those exact mutations are then used to design a personalized assay that looks for the same mutations in a blood sample or other body fluid. Because you are monitoring mutations confirmed to be present in the tumor, this method is highly sensitive and specific for detecting very small amounts of tumor DNA, and it can pick up subclones that might be missed by a generic panel.

Choosing random mutations would likely miss the true tumor profile and introduce noise. Relying on a single mutation risks false negatives if that clone decreases or isn’t representative of all residual disease. RNA-based markers can be informative in some settings, but DNA mutation tracking in cell-free DNA tends to be more stable and specific for MRD monitoring.