COMy 2021 | Advancing MRD monitoring in myeloma
The last decade has seen enormous growth of interest in measurable residual disease (MRD) as an accurate method to evaluate treatment efficacy in multiple myeloma. As well as substantial growth in its use as a clinical trial endpoint, methodological refinement has also been achieved. Bruno Paiva, PhD, University of Navarra, Pamplona, Spain, talks on the latest MRD techniques and how these are likely to become more advanced in the future. For example, next-generation techniques have enabled highly sensitive and standardized detection of MRD. Dr Paiva highlights the optimization of peripheral blood MRD measurement as an important next step. This interview took place during the 7th World Congress on Controversies in Multiple Myeloma (COMy), 2021.
Transcript (edited for clarity)
We have witnessed during the past six, ten years, tremendous revolution in the field of MRD in myeloma, both in terms of its incorporation in clinical trials, perhaps more recently, even in routine practice, but also in terms of methodology. There’s been remarkable methodological improvement. We have moved from non-standardized and low sensitive flow into next-generation flow and we have also moved from eventually ASO-PCR into next-generation sequencing...
We have witnessed during the past six, ten years, tremendous revolution in the field of MRD in myeloma, both in terms of its incorporation in clinical trials, perhaps more recently, even in routine practice, but also in terms of methodology. There’s been remarkable methodological improvement. We have moved from non-standardized and low sensitive flow into next-generation flow and we have also moved from eventually ASO-PCR into next-generation sequencing. PET-CT has emerged as the technique of choice for imaging MRD assessment, and in my opinion, the next big deal in terms of MRD assessment in myeloma is to more and more being able to perform it in blood, as opposed to bone marrow.
I would even say, to compliment a few bone marrow aspirates with more and more peripheral blood MRD assessment. How can this be achieved? I think that a first and very important step may be the progressive incorporation of mass spectrometry. A second and also very important step would be to increase, whenever possible, the sensitivity of current NGS and NGF assays, so that these can be also performed in peripheral blood with the high sensitive they achieve in bone marrow aspirates.
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