Dr. Gandara on Incorporating MRD Testing into Lung Cancer Practice

David R. Gandara, MD, discusses how minimal residual disease testing might be incorporated into lung cancer clinical practice.

David R. Gandara, MD, a professor, director of the Thoracic Oncology Program, and senior advisor to the director of the University of California Davis Comprehensive Cancer Center, discusses how minimal residual disease (MRD) testing might be incorporated into lung cancer clinical practice.

When it comes to technologic advances, including circulating tumor DNA, it is important to consider that there is a period in which the technology is researched before it moves into the standard of care, Gandara says. However, often in oncology, there is a period of time that can range from 1 to several years wherein the novel technology is in a state of transition; it is a period of time in which technologic advances such as an assay, test, or drug is not currently a standard of care, he explains.

MRD is currently in this period of transition and will likely require the results of a large randomized clinical trial such as the phase 3 MERMAID-1 (NCT04385368)—examining durvalumab (Imfinzi)/chemotherapy in fully resected stage II to III NSCLC—and MERMAID-2 (NCT04642469)—examining single-agent durvalumab in stage II or III NSCLC following curative intent therapy—trials, in order to help MRD testing transition to a standard of care.