Dr. Giralt on Evaluating MRD in Multiple Myeloma

Sergio A. Giralt, MD, professor of medicine at Weill Cornell Medical College, and chief, Adult Bone Marrow Transplant Service, Melvin Berlin Family Chair in Multiple Myeloma, at Memorial Sloan Kettering Cancer Center, discusses methods of evaluating measurable residual disease (MRD) in multiple myeloma.

MRD, commonly referred to as minimal residual disease, is somewhat of a misnomer, says Giralt, as it implies that the disease has been eradicated. However, that is not always the case. As such, measurable residual disease might be a more appropriate term, he suggests. Currently, 2 assays are available to measure MRD, including next-generation sequencing and flow cytometry. These assays have a sensitivity that ranges from 1 in 100,000,000 to 1 in 1,000,000,000 myeloma cells in the bone marrow.

MRD negativity has been shown to be a positive prognostic outcome. However, it is unknown whether converting an MRD-positive patient to an MRD-negative patient has any impact on survival, and what the ideal timing to measure MRD is, says Giralt. As such, MRD is not currently being used to guide treatment decisions in multiple myeloma, concludes Giralt.