SOHO 2019: Is Minimal Residual Disease Testing Ready for Prime Time?
Posted: Monday, September 23, 2019
According to a presentation at the 2019 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract EXABS-MM-437), minimal residual disease (MRD) testing should not currently be used to make treatment decisions for patients with multiple myeloma. “MRD results provide prognostic information only, and future clinical trials with adaptive designs will define how MRD can guide treatment decisions,” concluded Thomas Martin, MD, of the University of California, San Francisco.
Briefly, MRD testing is used to measure small amounts of clonal plasma cells that may remain in the bone marrow despite a patient appearing to achieve a stringent complete response. Stringent complete response is associated with improved survival outcomes, and studies support MRD testing as a more accurate indicator of remission depth, according to Dr. Martin. In addition, the testing may also serve as an early surrogate marker for progression-free and overall survival.
However, many specifics of MRD assessment implementation remain in debate, particularly between clinical trial data and the International Myeloma Working Group response criteria, often regarded as an international assessment standard. Some studies may use multicolor flow cytometry, whereas others use next-generation sequencing; in addition, some studies perform testing after 6 cycles, whereas others assess after 12 cycles. Because various studies are abiding by different assessment techniques, it is difficult to reach definitive conclusions through comparison, cautioned Dr. Martin. Therefore, Dr. Martin said, treatment decisions should not be made based on MRD data until optimal testing practices are identified and universally adopted.
Disclosure: The study authors’ disclosure information may be found at sohoonline.org.
