MRD Use in Multiple Myeloma: Clinical Practice, Clinical Trials, and Drug Approval

In this episode of the “Blood Cancer Talks” podcast, host Raj Chakraborty, MD, spoke with Benjamin Derman, MD; and Manni Mohyuddin, MBBS, about the use of measurable residual disease (MRD) in multiple myeloma (MM).

This expert panel discussion followed the April 2024 meeting of the US Food and Drug Administration Oncologic Drugs Advisory Committee (ODAC). At the meeting, ODAC approved the use of MRD as a surrogate endpoint for accelerated approval in MM clinical trials.

The experts emphasized that MRD is used differently in clinical practice than in clinical trials or the drug regulatory approval process. They discussed the prognostic value of MRD in MM, the degree to which MRD correlates with survival outcomes, and the limits of using MRD as a measure of treatment efficacy. They also debated whether MRD negativity should be a treatment goal in MM management.

The panel also reviewed the role of MRD in MM treatment decision-making. On this subject, Dr. Derman described the preliminary findings from his MRD2STOP study investigating how MRD factors into decisions about whether to discontinue MM maintenance therapy.