Looking with greater and greater accuracy for persistent cancer cells can help better inform when to stop and maybe when to intensify treatment.
Flow cytometry that looks at markers on the cell surface can find one in ten thousand CLL cells.
Next generation sequencing (NGS) that looks at the cancer’s unique gene sequencing may be able to find one in a million cells.
Even at that level, there still may be many, many cancer cells left but they are too few to be detectable with present technology. And if the number left is low enough, it may not ever become clinically significant.
Knowing the depth of the remission already has proven prognostic implications. Research is now looking at how this information might guide therapy is in process.
Until last week, getting the NGS testing, specifically clonoSEQ, was not a covered lab test for those with Medicare, but as of Jan. 8. 2020 it is. And what is covered by Medicare usually ends up being covered by most medical insurances.
For the Adaptive Biotechnologies’ press release, please see here.
For more on the underlying science, see this.
This is a complicated issue that involves some nuanced discussion. We will write more on MRD testing, but for now I wanted to share the good news of the approved coverage.
We are all in this together.
Brian Koffman MDCM (retired), MS Ed
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.