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ASCO 2026 | Impact of sustained MRD negativity on outcomes in transplant-eligible newly diagnosed myeloma
Mattia D’Agostino, MD, University of Turin, Turin, Italy, discusses the impact of sustained measurable residual disease (MRD) negativity on long-term outcomes in transplant-eligible patients with newly diagnosed multiple myeloma (MM) enrolled in the Phase II FORTE trial (NCT02203643). Dr D’Agostino notes that sustained MRD negativity for more than three years significantly improved long-term progression-free survival (PFS) and overall survival (OS) rates, including among patients with high-risk disease at baseline. Among patients who achieved at least five years of sustained MRD negativity, the 7-year PFS was encouraging at 91%. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
So reaching MRD negativity is the single most powerful prognostic factor in multiple myeloma and we know that with novel treatments we can reach MRD negativity in a very high portion of patients. However, the challenge is to sustain it and we know that sustained MRD negativity outperforms single-time point MRD negativity in the prediction of long-term outcomes. However, the optimal duration of MRD negativity to predict long-term PFS is still unknown...
So reaching MRD negativity is the single most powerful prognostic factor in multiple myeloma and we know that with novel treatments we can reach MRD negativity in a very high portion of patients. However, the challenge is to sustain it and we know that sustained MRD negativity outperforms single-time point MRD negativity in the prediction of long-term outcomes. However, the optimal duration of MRD negativity to predict long-term PFS is still unknown. Thus, we looked at the effect of different durations of sustained MRD negativity in the Phase II FORTE trial enrolling transplant-eligible newly diagnosed multiple myeloma patients.
We found that at least one-third of the patients randomized to maintenance reached three years of sustained MRD negativity. And three years, sustained MRD negativity really improved the long-term PFS and OS of our patients with a seven-year OS rate of 97% and a seven-year PFS rate that was above 80%. So we then looked at some subgroup analyses looking at high-risk cytogenetics at baseline, and what we found is that once you reach three years sustained MRD negativity in the bone marrow, then it doesn’t matter if you have high risk at the beginning, your outcome is going to be good anyway. Thus, reaching at least three years of sustained MRD negativity is very important in newly diagnosed multiple myeloma patients. We then pushed our analysis to five years of sustained MRD negativity and we found that this population of patients has an exceptional seven-year PFS rate of 91%.
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