Dr. Mark on Establishing MRD as a Surrogate Marker for Survival in Multiple Myeloma

Tomer Mark, MD, clinical director, Plasma Cell Disorders Program, University of Colorado Health, discusses establishing minimal residual disease (MRD) as a surrogate marker for survival in multiple myeloma.

Although MRD is not universally accepted as a surrogate marker for survival, it is being incorporated into numerous clinical trials and may represent an improved marker compared with International Myeloma Working Group criteria, Mark says.

Additionally, more patients are achieving MRD negativity status, Mark explains. This is true even in the relapsed/refractory setting, with the advent of CAR T-cell therapies, such as idecabtagene vicleucel (Abecma) and ciltacabtagene autoleucel; these products are associated with a MRD-negativity rate of around 50%.

Other regimens leveraging monoclonal antibodies, such as the combination of daratumumab (Darzalex), lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone, are also demonstrating continued MRD negativity in patients with newly diagnosed multiple myeloma, Mark says. However, although certain approaches are inducing deep and durable responses in patients, questions regarding the optimal sequencing of therapy remain unanswered, Mark concludes.