Minimal residual disease (MRD) negativity after treatment is associated with prolonged overall survival in patients with newly diagnosed multiple myeloma, according to a study published in JAMA Oncology.1
Although numerous studies have assessed the prognostic impact of MRD in patients with multiple myeloma, there were several limitations that affected the significance of their findings. Therefore, researchers sought to evaluate the utility of MRD detection in more than 1000 patients included in various studies.
For the study, investigators analyzed data from 1273 patients with newly diagnosed multiple myeloma who participated in studies published between 1990 and 2016.
Results showed that, overall, MRD negativity was associated with a 59% reduction in the risk of disease progression (hazard ratio [HR], 0.41; 95% CI, 0.36-0.48; P <.001). Among patients who achieved a complete response to initial therapy, risk of progression was 66% lower in those with an MRD-negative status (HR, 0.44; 95% CI, 0.34-0.56; P <.001).
Overall, patients with MRD-negative status after initial treatment had significantly improved overall survival (HR, 0.57; 95% CI, 0.46-0.71; P <.001). Similarly, in those who achieved a complete response, MRD negativity was associated with a 53% reduction in the risk of death (HR, 0.47; 95% CI, 0.33-0.67; P <.001
These findings ultimately support the use of MRD status as a marker of long-term outcomes in patients with multiple myeloma, and should therefore be incorporated as a new end point and surrogate marker of overall survival in clinical trials.
1. Munshi NC, Avet-Loiseau H, Rawstron AC, et al. Association of minimal residual disease with superior survival outcomes in patients with multiple myeloma. JAMA Oncol. 2016 Sep 15. doi: 10.1001/jamaoncol.2016.3160. [Epub ahead of print]