According to results of a study published in the Journal of Clinical Oncology, favorable outcomes were observed for patients with newly diagnosed, transplant-eligible multiple myeloma who achieved minimal residual disease (MRD)-negative status as assessed by next-generation flow cytometry — irrespective of disease cytogenetics or the timing of the assessment of MRD negativity.1
The depth of response as measured by MRD — which is the presence of residual myeloma cells not detected by conventional morphological methods — has been shown to correlate with risk of disease relapse in patients with multiple myeloma achieving complete remission. However, the use of lower-sensitivity methods for MRD detection (ie, through older flow cytometry technologies), only showed a 60% reduction in the risk of disease progression or death when patients with multiple myeloma who were characterized as having MRD-negative vs MRD-positive disease were compared.
Newer, more sensitive methods for evaluating MRD status in the setting of multiple myeloma are evolving, and include next-generation sequencing for the detection of clonal immunoglobulin VDJ gene rearrangements, and next-generation flow cytometry.
The latter method, used in this study, is a 2-tube assay involving 8-color antibody panels that evaluate surface antigens on, as well as light-chain expression within, plasma cells.2
Positron emission tomography/computed tomography (PET/CT) imaging are other tests used for detection of MRD in multiple myeloma.
This study utilized longitudinal data on patient MRD status, assessed using next-generation flow cytometry, that were prospectively collected during the open-label, phase 3 PETHEMA/GEM2012MENOS65 clinical trial (ClinicalTrials.gov Identifier: NCT01916252), in which 458 patients with newly diagnosed, transplant-eligible multiple myeloma were randomly assigned to receive (following induction therapy) 6 cycles of bortezomib/lenalidomide/dexamethasone (VRD) to receive busulfan plus melphalan or high-dose melphalan, which was then followed by autologous transplantation and 2 consolidation cycles of VRD.
And, 28%, 42%, and 45% of patients in the intent-to-treat population patients were classified as MRD-negative following induction therapy, autologous transplantation, and consolidation therapy, respectively. Sixty-one patients stopped treatment following induction therapy and though there was no MRD data on them, they were considered to be MRD-positive for intent-to-treat analysis.
This article originally appeared on Cancer Therapy Advisor