Minimum Residual Disease: A Surrogate Marker for Assessing Outcomes in Multiple Myeloma

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Patients who presented with an MRD level below 10-6 had a significantly improved PFS compared with patients who were above this threshold.
Patients who presented with an MRD level below 10-6 had a significantly improved PFS compared with patients who were above this threshold.
The following article features coverage from the American Society of Hematology (ASH) 2017 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

A minimal residual disease (MRD) cutoff of 10-6 may be used as a novel surrogate biomarker for trial evaluation and be a predictor of progression-free survival (PFS) and overall survival (OS) outcomes among patients with multiple myeloma (MM), according to findings presented at the 2017 American Society of Hematology (ASH) Annual Meeting in Atlanta, Georgia.1

With improvements in medical technology and novel drugs, the complete response rate — once a standard endpoint for clinical trials — has improved beyond the point of being a meaningful clinical measurement.

For the IFM2009 trial, researchers randomly assigned 700 patients with MM who initially received lenalidomide, bortezomib, and dexamethasone (RVD) induction to continue RVD vs undergoing transplantation conditioned by high-dose melphalan, followed by 12 months of lenalidomide maintenance therapy. MRD was evaluated before and after maintenance therapy in 269 patients who had at least a very good partial response (VGPR). Patients who did not have a VGPR were considered MRD positive.

After a median follow-up of 55 months, patients with MRD below 10-6 did not reach an evaluable median PFS compared with 29 months among patients with MRD above 10-6.

Patients who reached the MRD threshold of 10-6 had similar PFS outcomes regardless of whether they underwent transplant, and patients with MRD negativity had a significantly improved OS compared with patients who did not.

The authors concluded that “MRD could (should?) be considered as a novel surrogate biomarker for trial evaluation.”

Read more of Cancer Therapy Advisor's coverage of the American Society of Hematology (ASH) 2017 meeting by visiting the conference page.

Reference

  1. Avet-Loiseau H, Lauwers-Cances V, Corre J, Moreau P, Attal M, Munshi N. Minimal residue diease in multiple myeloma: final analysis of the IFM2009 trial. Oral presentation at: American Society of Hematology 59th Annual Meeting & Exposition; December 9-12, 2017; Atlanta, GA.

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