Posted: Tuesday, June 27, 2023
Modulating therapy in the context of achieved measurable residual disease (MRD) negativity may be associated with improved outcomes, according to a presentation at the European Hematology Association (EHA) 2023 Hybrid Congress (Abstract S203). Luciano Costa, MD, of the University of Alabama at Birmingham, and colleagues explained: “Quadruplet therapy increases the depth and duration of response in newly diagnosed multiple myeloma patients. In patients receiving the same therapy in the context of clinical trials, the achievement of MRD negativity is associated with improved outcomes, yet the use of MRD assessment to modulate therapy in newly diagnosed multiple myeloma remains elusive.”
A total of 123 patients with multiple myeloma were enrolled in the MASTER study and received induction therapy, which included daratumumab, carfilzomib, lenalidomide, and dexamethasone, followed by autologous stem cell transplantation. The duration of therapy was dictated by achievement of MRD negativity in two consecutive phases. Patients who achieved MRD negativity were moved to observation, whereas those who did not reach this milestone received maintenance with lenalidomide.
The authors reported that MRD negativity was reached in 81% of patients. Sustained MRD negativity (> than 12 months) was achieved in 61% of patients. Furthermore, MRD surveillance was reached by 84 patients with treatment cessation. These patients had a median follow-up from cessation of therapy of 32.7 months.
Patients with either no or one cytogenetic risk factor had a 2-year cumulative risk of disease progression of 9%, whereas those who had more cytogenetic risk factors had a 47% cumulative risk of disease progression. Progression-free survival was reported to be 82% for patients who achieved sustained MRD negativity compared with 55% who did not. A total of 23 patients resumed therapy attributable to disease progression or MRD resurgence, but 61 remained therapy-free with sustained MRD negativity.
Disclosure: Disclosure information for the study authors was not provided.