Real-World Use of Measurable Residual Disease Testing in Multiple Myeloma
Posted: Wednesday, November 25, 2020
Based on the results of a data analysis evaluating the impact of the depth, duration, and direction of measurable residual disease response on the prognosis of 234 patients with multiple myeloma, Jeffrey Wolf, MD, of the University of California, San Francisco, and colleagues believe that measurable residual disease assessment is ready to be incorporated into real-world clinical practice. “We look forward to prospective validation of this,” they wrote in Blood Advances.
These data “support the role of measurable residual disease assessment in the prediction of [progression-free] survival,” asserted the team. “Depth of response and measurable residual disease dynamics…ultimately could drive clinical decision-making, potentially improving the outcome of multiple myeloma patients.”
The work currently validates measurable residual disease as an important prognostic marker in both newly diagnosed and relapsed or refractory multiple myeloma, they noted. Their patient cohort included 159 and 75 patients in those groups, respectively.
All measurable residual disease assessments were performed by next-generation sequencing of immunoglobulin genes with a sensitivity of 10−6, explained Dr. Wolf and co-investigators. “Those achieving measurable residual disease negativity at 10−6, as well as 10−5, had superior median progression-free survival,” they summarized.
Specifically, 40% of newly diagnosed patients achieved measurable residual disease negativity at 10−6 and 59% at 10−5, and median progression-free survival in the newly diagnosed cohort was longer in those achieving measurable residual disease at 10−5 vs < 10−5 (87 vs. 32 months; P < .001). Among those with relapsed or refractory disease, 36% achieved measurable residual disease negativity at 10−6 and 47% at 10−5. In this cohort, median progression-free survival was also superior for those achieving measurable residual disease at 10−5 (42 months) vs < 10−5 (17 months; P < .01).
Disclosure: The study authors’ disclosure information can be found at ashpublications.org.
