COMy 2019 | The importance of MRD assessment in Myeloma with Prof. Mateos

Maria-Victoria Mateos

María-Victoria Mateos, MD, PhD, of the University Hospital of Salamanca, Salamanca, Spain, states that measuring in depth the complete response for patients with multiple myeloma (MM) is becoming increasingly important as we achieve better levels of overall and complete response rates. Dr Mateos explains that this is because there is no plateau phase for time to progression and overall survival curves. Furthermore, that this is achieved through assessing MRD using next-generation flow (NGF) and sequencing (NGS). Finally, Dr Mateos goes on to say that highly specific NGF and NGS hold the key to identifying potentially curable patients. This interview took place at the Controversies in Multiple Myeloma (COMy) 2019 World Congress in Paris, France.

Transcript (edited for clarity):

Minimal Residual Disease (MRD) is becoming more and more important in the management of our patients with multiple myeloma and there are some reasons.

First, because we have many new combinations that are resulting in a high overall response rate and especially, very high complete response rate, now we can reach up to 50% complete response rate in the [inaudible] setting. And we know that in spite of [this], complete response is also a good surrogate marker, but predicting progression-free survival and overall survival there is not any plateau phase in an either time to progression or overall survival.

And this is the reason why we need to evaluate the complete response in depth and we have to go to evaluate the minimal residual disease outside of the bone marrow, through the use of PET CT but also inside of the bone marrow using next-generation flow or next-generation sequencing but an important message is that we have to evaluate minimal residual disease with a high sensitivity level. This has been clearly demonstrated in prospective trials conducted by both Spanish and French myeloma groups and when we use either next-generation flow or next-generation sequencing with a sensitivity level of at least 10-6 we are able to identify a so group of patients in which the outcome is excellent.

So the final objective would be [for] our myeloma patients to reach minimal residual disease inside and outside of the bone marrow and I think that we are going to identify patients that can potentially be cured.

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