IMS 2023 | MRD dynamics in multiple myeloma: current approaches and unanswered questions
Karthik Ramasamy, MBBS, MRCP, FRCPath, PhD, Oxford University Hospitals NHS Foundation Trust, Oxford, UK, discusses the importance of measurable residual disease (MRD) in multiple myeloma, highlighting the advantage of using protein-based methods of assessment. Dr Ramasamy also shares insights into unanswered questions regarding MRD in this disease. This interview took place at the 20th International Myeloma Society (IMS) Annual Meeting, held in Athens, Greece.
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Transcript (edited for clarity)
MRD (measurable residual disease) in myeloma is an important area of active research. We have found consistently that people who have lower levels of measurable residual disease tend to have a longer progression-free survival and overall survival. But within this particular space, what’s now becoming clearer is that you can measure the cells, you can measure the DNA, and you can measure protein...
MRD (measurable residual disease) in myeloma is an important area of active research. We have found consistently that people who have lower levels of measurable residual disease tend to have a longer progression-free survival and overall survival. But within this particular space, what’s now becoming clearer is that you can measure the cells, you can measure the DNA, and you can measure protein. So, there are multiple methodologies here. One advantage of having a protein-based measurement in blood is that it gives you the ability to do frequent assessments in comparison to bone marrow-based flow cytometry, as well as next-generation sequencing using DNA. The unanswered questions here are: does earlier achievement of MRD-negativity talk to disease biology in these patients? And should we be watching MRD more closely using blood-based biomarkers, followed by marrow-based MRD methodology – is that a cleverer way of following patients up? The final question is, because there are a range of therapeutics now becoming available in myeloma, are there opportunities to start therapy early for patients relapsing, and give them more fixed duration therapy rather than continuous therapy when patients have full blown relapse? So, this field continues to develop, and I’ll be excited to watch the new presentations in the next few years.
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