COMy 2019 | Coupling imaging and molecular techniques to determine MRD in MM
Elena Zamagni, MD, PhD, of the University of Bologna, Bologna, Italy, discusses the importance of combining techniques when determining MRD negativity in patients treated for MM. Not only is it important to conduct assessments inside the bone marrow using next-generation flow (NGF) and sequencing (NGS), but also to look beyond this and use imaging techniques such as PET-CT scans. Furthermore, Dr Zamagni discusses future techniques that may play a role in MRD determination. This interview took place at the Controversies in Multiple Myeloma (COMy) 2019 World Congress in Paris, France.
Transcript (edited for clarity)
So, by now they are complementary, so in patients where you really wanted to state that they are MRD negative after therapy you have to use both; so one bone marrow technique either NGS or NGF and PAT or [inaudible] MRI outside the bone marrow. Of course, if you find the positivity in the bone marrow you may not go for a PET CT because you are already aware that the patient is MRD positive, but if you want really to state a negative status you have to look at both because as I said they are complementary...
So, by now they are complementary, so in patients where you really wanted to state that they are MRD negative after therapy you have to use both; so one bone marrow technique either NGS or NGF and PAT or [inaudible] MRI outside the bone marrow. Of course, if you find the positivity in the bone marrow you may not go for a PET CT because you are already aware that the patient is MRD positive, but if you want really to state a negative status you have to look at both because as I said they are complementary. Maybe in the future circulating DNA and liquid biopsy may play a role but we don’t have any answer by now.
The job that we did by now is regarding FDG, PET CT. We use for the first time they don’t build score criteria that are largely in news for lymphomas and we were able to identify that the score for the reference of the liver is the most representative of the outcomes of patients so what we proposed with this prospective joint analysis is to use the liver as a reference for positivity or negativity after therapy, so we believe that this is very important for pay for people in clinical practice.
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