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EHA 2025 | The key challenges and future of MRD assessment in multiple myeloma
Bruno Paiva, PhD, University of Navarra, Pamplona, Spain, discusses the key challenges and future of measurable residual disease (MRD) assessment in multiple myeloma. He notes that MRD is a powerful prognostic tool, but challenges remain in standardizing the process. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
Well, I think that MRD assessment in the bone marrow of patients with myeloma is well established, clearly consolidated; it’s one of the most powerful prognostic factors, if not the most powerful prognostic factor. It’s the typical biomarker used in clinical trials. Now it’s a dual primary endpoint in many ongoing and future clinical trials. So in my view there are two challenges ahead...
Well, I think that MRD assessment in the bone marrow of patients with myeloma is well established, clearly consolidated; it’s one of the most powerful prognostic factors, if not the most powerful prognostic factor. It’s the typical biomarker used in clinical trials. Now it’s a dual primary endpoint in many ongoing and future clinical trials. So in my view there are two challenges ahead. On the one hand, complement MRD assessment in the marrow with MRD assessment in the blood. We like to call it peripheral residual disease or PRD. So I think that the sequential use of MRD and PRD will be the next frontier in terms of response assessment in myeloma. This has a lot of advantages. It will provide more information, eventually information that is needed to tailor treatment according to depth of response. And it will be much more convenient to patients because it’s blood or serum and it’s minimally invasive on the one hand. On the other hand, guidance on how to use MRD and PRD for tailored approaches. This can only be developed after the readout of some of the ongoing clinical trials. And finally, complete standardization of MRD and PRD assessment in routine practice. If we believe that MRD is here to stay in myeloma and will be used more and more, not only for clinical trials, but also in routine practice, it must be monitored the same way, the same optimal and standardized way we are doing it in clinical trials.
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