Dr. Usmani on Minimal Residual Disease in Multiple Myeloma

Saad Z. Usmani, MD, clinical professor of medicine, UNC-Chapel Hill School of Medicine, chief, Plasma Cell Disorders Program, director, clinical research in hematologic malignancies, Levine Cancer Institute, discusses the impact of minimal residual disease (MRD) on clinical practice.

Depth of response is an important part of myeloma treatment, as are clinical trials that have examined MRD negativity with different methodologies. These prospective studies have shown that regardless of which technique is used, whether it is flow cytometry or sequencing, that better depth of response beyond the conventional complete response or stringent complete response is associated with better overall survival outcomes.

The next step, notes Usmani, is utilizing MRD as a potential surrogate for survival to then stop therapy, or determine if something more needs to be done to achieve MRD negativity in a given patient. These are unanswered questions, says Usmani. Ultimately, MRD status should not be used to change treatment.