Dr. Fonseca on the Emergence of MRD in Multiple Myeloma

Rafael Fonseca, MD, interim director, Mayo Clinic Cancer Center, director, Innovation and Transformational Relationships, Mayo Clinic, discusses the emergence of minimal residual disease (MRD) in multiple myeloma.

Although the utility of MRD remains somewhat controversial in multiple myeloma, ClonoSEQ, a next-generation sequencing assay that evaluates MRD, was approved in September 2018 for patients with multiple myeloma or acute lymphoblastic leukemia. Additional methods for measuring MRD, such as EuroFlow and Mass Spectrometry, are currently under investigation in this space.

However, despite this approval, how to best utilize MRD as a biomarker to inform treatment decisions remains a largely unanswered question in myeloma, Fonseca explains. In clinical practice, Fonseca says that routinely testing for MRD is important for patients who complete transplants on day 100, as well as those who achieve deep and durable complete remissions. Moreover, it is important to discuss the results of MRD assessments with patients as those who are MRD negative appear to have a reduced risk of relapse compared with MRD-positive patients, concludes Fonseca.