Targeting Minimal Residual Disease

Minimal residual disease (MRD) represents a significant challenge in the treatment of various cancers, acting as a precursor to relapse and therapeutic resistance. This review discusses the clinical background of MRD, exploring its role as a critical determinant in patient outcomes. The persistence of MRD is attributed to several mechanisms, including Darwinian selection of preexisting resistant clones, Lamarckian induction of resistance traits, and pharmacologic resistance due to the tumor's intrinsic barriers to drugs and treatment limitations. These processes underscore MRD as the seed for long-term drug resistance, complicating treatment efficacy. Addressing MRD requires innovative therapeutic strategies, ranging from targeted therapies to novel drug combinations, aimed at eradicating these resilient cancer cells. By understanding and targeting MRD, we could improve patient prognoses and develop more effective cancer treatments. This review synthesizes current knowledge and emerging approaches in the quest to manage and eliminate MRD.