# Measuring treatment response and residual disease in leukemia with personalized, sensitive, and quantitative genomic methods

> **NIH NIH R00** · EMORY UNIVERSITY · 2023 · $249,000

## Abstract

Project Summary
To improve patient outcome in cancer, better methods are urgently needed to measure therapeutic response 
and detect early relapse. In acute myeloid leukemia (AML), 50% of patients in remission will relapse within 2 
years. Current methods lack the sensitivity and generality to detect minimal residual disease (MRD) in all of 
those patients. Multiplex Accurate Sensitive Quantitation (MASQ), is both sensitive and general. It can target up 
to 50 patient-specific mutations, with sequence error rates reduced to 1 in 1 million, and count mutant DNA 
molecules with molecular tags. In a pilot study of AML, MASQ detected somatic variants at levels ranging from 
1 in 100 to nearly 1 in 1 million, with higher mutation frequencies in patients who relapsed. There is also a critical 
need to interpret minimal residual disease in the context of pre-leukemic clonal hematopoiesis and the evolution 
of leukemic cells. Relapse may arise from drug-resistant leukemic cells, a genetically diverged subclone, or a 
reservoir of pre-leukemic stem cells. In this proposal, I apply and improve innovative genomic tools for measuring 
treatment response, predicting clinical outcome, and investigating the nature of residual cells in AML. 
This project utilizes a large observational clinical study of AML to track patient-specific leukemia-associated 
variants in blood samples taken over the course of the disease. Aim 1 will analyze subclonal treatment response 
and the dynamics of relapse by tracking leukemia-associated variant allele frequencies across time. Aim 2 will 
establish the prognostic value of a personalized, highly sensitive, and quantitative test for residual disease in 
AML. Aim 3 proposes to isolate the rare residual cells harboring leukemia-associated variants from a remission 
blood sample to determine the genomic and transcriptomic profiles that may provide further biological and clinical 
insight into the disease. 
I have proposed a tailored career development plan that will prepare me for my transition to independence. 
Following my postdoctoral fellowship training, I aim to be an independent tenure-track professor at a major 
research university. The training environment at Cold Spring Harbor Laboratory (CSHL) provides access to 
world-renowned meetings and courses, and a plethora of investigators with expertise in cancer and quantitative 
biology. My professional development activities center around mentorship, communication, teaching, lab 
management, and preparing for the academic job search. My training will also include coursework in clinical 
translation and single cell analysis; presentations at conferences in genome informatics, cancer biology, and 
liquid biopsy; and mentored research goals under the guidance of my mentor Dr. Michael Wigler and my co-mentor Dr. Dan Levy. I have assembled a team of additional scientific advisors and collaborators including Dr. 
David Tuveson and Dr. Christopher Vakoc from CSHL and Dr. Steven Allen ...

## Key facts

- **NIH application ID:** 10818005
- **Project number:** 4R00CA252616-03
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Andrea Moffitt
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $249,000
- **Award type:** 4N
- **Project period:** 2020-07-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10818005

## Citation

> US National Institutes of Health, RePORTER application 10818005, Measuring treatment response and residual disease in leukemia with personalized, sensitive, and quantitative genomic methods (4R00CA252616-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10818005. Licensed CC0.

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