Dr. Diamond on the Need to Integrate MRD Testing Into Clinical Trials in Multiple Myeloma

Benjamin Diamond, MD, a hematology-oncology fellow at Memorial Sloan Kettering Cancer Center, discusses the need to integrate minimal residual disease (MRD) testing into clinical trials in multiple myeloma.

Although MRD does not currently inform treatment decisions for patients with multiple myeloma, MRD-oriented clinical trials are needed to determine the utility of MRD negativity in this patient population. Moreover, some clinical trials are incorporating risk-adapted approaches based on MRD, says Diamond. In these studies, patients undergo MRD assessment a number of years following induction and maintenance therapy. Then, based on the results of the test, patients may continue on their treatment or de-escalate therapy, Diamond explains.

In practice, patients may be allowed to defer stem cell transplant if they are MRD negative following induction therapy, Diamond says. This is based on findings from the phase 3 IFM 2009 trial (NCT01191060), which showed that time to second objective disease progression and overall survival was similar whether patients received an early or delayed transplant, Diamond concludes.