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COMy 2019 | Depth of MRD assessment in MM

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Graham Jackson

Graham Jackson, MBBS, FRCP, FRCPath, MD, Newcastle upon Tyne Hospitals NHS Trust, Newcastle, UK, discusses the methods for assessing measurable residual disease (MRD) in patients with multiple myeloma (MM), as well as the importance of the depth of measurement. This interview took place at the Controversies in Multiple Myeloma (COMy) 2019 World Congress in Paris, France.

Transcript (edited for clarity):

One of the important features of assessing our treatments going forward in multiple myeloma is MRD assessment. Clearly we have a number of different tools to assess minimal residual disease including Flo and next-generation sequencing, and there is clear data now showing that MRD negativity associates with good outcomes for our patients. And some really nice data now showing that the depth of MRD assessment is associated with better responses so the deeper your MRD assessment, if you’re MRD negative on those deep assessments then you have a very good outcome...

One of the important features of assessing our treatments going forward in multiple myeloma is MRD assessment. Clearly we have a number of different tools to assess minimal residual disease including Flo and next-generation sequencing, and there is clear data now showing that MRD negativity associates with good outcomes for our patients. And some really nice data now showing that the depth of MRD assessment is associated with better responses so the deeper your MRD assessment, if you’re MRD negative on those deep assessments then you have a very good outcome.

And as we look at our trials and the progression-free survival and overall survival readouts take so long to come out from studies, MRD negativity as a surrogate endpoint is going to be increasingly important. Of course you have to remember that we don’t only measure it by measuring assessment of the disease, but we need to look at radiological assessment and clearly we’ve heard this meeting updates on PET CT scanning too.

So if we’re going to look at MRD negativity we need to look at it by either next-generation sequencing which is probably the best and deepest assessment but also with PET CT scanning. In the UK we’ve largely used flow cytometric assessments at ten to the five and that’s still a very good assessment of MRD negativity but going forward whether that’ll be sufficient for clinical trials is is difficult to say.

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