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MRD Assessment in Multiple Myeloma: Progress and Challenges

  • Multiple Myeloma (P Kapoor, Section Editor)
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Abstract

Purpose of Review

Over the last decade, the development of effective treatment approaches for multiple myeloma (MM) has been associated with higher response rates and longer survival. In patients who achieve complete response, several high sensitivity techniques have been studied to assess minimal residual disease (MRD) and detect residual neoplastic cells within the bone marrow (by flow cytometry or molecular biology techniques) or outside the bone marrow (by imaging or circulating disease markers in the peripheral blood). This is of utmost importance, since residual disease can drive clinical relapse. This review focuses on the progress made in the assessment of MRD in MM.

Recent Findings

The achievement of MRD negativity after therapy is considered prognostically important for MM patients, and data from clinical trials and meta-analyses have confirmed that it is strongly associated with better survival. Along with well-known techniques, such as next-generation sequencing (NGS), next-generation flow (NGF), and positron emission tomography/computed tomography (PET/CT), other methods such as mass spectrometry (MS) and circulating tumor cells are under study. Intensive treatment regimens at diagnosis can lead up to 70% of MRD negativity in MM patients, although the current proportion of curable patients is still unknown.

Summary

Today, clinicians who treat MM deal with MRD assessment in routine clinical practice. Its appropriate use in therapeutic decision making may be the most fascinating and challenging issue to be addressed over the next few years.

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  1. Luca Bertamini and Mattia D’Agostino equally contributed to this manuscript and share first authorship.

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  1. Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, via Genova 3, 10126, Torino, Italy

    Luca Bertamini, Mattia D’Agostino & Francesca Gay

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All authors conceived and designed the work that led to the submission.

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Correspondence to Francesca Gay.

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LB declares no competing financial interests.

MD has received honoraria for lectures from Sanofi and GSK and has served on the advisory boards for GSK.

FG has received honoraria from Amgen, Celgene, Janssen, Takeda, Bristol-Myers Squibb, AbbVie, and GSK and has served on the advisory boards for Amgen, Celgene, Janssen, Takeda, Bristol-Myers Squibb, AbbVie, GSK, Roche, Adaptive Biotechnologies, Oncopeptides, Bluebird, and Secura Bio.

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Bertamini, L., D’Agostino, M. & Gay, F. MRD Assessment in Multiple Myeloma: Progress and Challenges. Curr Hematol Malig Rep 16, 162–171 (2021). https://doi.org/10.1007/s11899-021-00633-5

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