Myriad Genetics has expanded the clinical availability of its Precise MRD™ test, a molecular residual disease (MRD) assay designed to detect circulating tumor DNA (ctDNA) in patients with solid tumors. The test, which utilizes whole-genome sequencing to monitor for cancer recurrence, is now accessible to a broader range of clinical oncologists and healthcare systems for post-surgical surveillance.
How Precise MRD™ Functions in Cancer Surveillance
Precise MRD™ is a liquid biopsy test that identifies ctDNA—tiny fragments of genetic material shed by tumors into the bloodstream. According to Myriad Genetics, the process begins with an initial analysis of a patient’s tumor tissue to create a personalized genomic profile. Once this baseline is established, the test performs serial blood draws to monitor for the presence of tumor-specific mutations.
This approach aims to detect molecular recurrence before it becomes visible on standard imaging scans, such as CT or PET. By identifying residual disease at a molecular level, clinicians may be able to adjust treatment plans earlier. The technology relies on high-depth sequencing to ensure sensitivity, which is critical when the concentration of tumor DNA in the blood is extremely low.
Why Molecular Residual Disease Testing Matters
The clinical goal of MRD testing is to improve long-term outcomes by shifting cancer management from reactive to proactive. Traditional surveillance often relies on imaging, which may only detect a recurrence once a tumor has reached a certain physical size.
Data from the National Cancer Institute underscores that identifying residual disease early can provide a window for adjuvant therapy or clinical trial enrollment. While imaging remains the gold standard for clinical diagnosis, molecular testing acts as a sensitive, non-invasive supplement that can signal potential relapse months or even years before physical symptoms appear.
Comparison of MRD Approaches
Precise MRD™ joins a growing field of liquid biopsy diagnostics. When evaluating these tools, oncologists generally compare them based on their methodology:
- Tumor-Informed Assays: These require an initial sample of the patient’s tumor to build a personalized test. Precise MRD™ falls into this category, as it uses the patient’s unique genomic signature to track recurrence.
- Tumor-Agnostic Assays: These look for common mutations across broad cancer types without requiring a baseline biopsy of the primary tumor.
While tumor-informed tests like the one from Myriad are generally considered highly sensitive for the specific patient, they require successful tissue sampling. Tumor-agnostic tests offer faster turnaround times but may occasionally lack the same level of personalized sensitivity.
Clinical Considerations for Patients and Providers
The expansion of this test provides oncologists with more options for longitudinal monitoring. However, the interpretation of ctDNA results remains complex. A positive MRD result indicates the presence of molecular disease, but it does not always correlate with immediate clinical progression.
According to guidelines from the American Society of Clinical Oncology (ASCO), the integration of liquid biopsies into routine practice is evolving. Providers must balance the high sensitivity of these assays with the psychological impact of a positive result on patients, especially in cases where no immediate clinical intervention has been validated by large-scale, randomized controlled trials. As of 2024, the utility of MRD testing continues to be a primary focus of research in clinical oncology, with ongoing studies assessing how these results should dictate changes in systemic therapy.