A systematic review and meta-analysis presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology compared survival rates between measurable residual disease (MRD)-positive and MRD-negative newly diagnosed, transplant-eligible patients with multiple myeloma (MM).
The authors conducted a comprehensive literature search in PubMed, Cochrane, and Embase databases, covering studies from 2013 to 2023. After screening 832 articles, they included 14 phase II, phase III, and retrospective studies that involved a total of 4,118 patients. MRD status was assessed with multiparameter flow cytometry and next-generation sequencing. Induction regimens included proteasome inhibitors, immunomodulatory drugs, and daratumumab.
The analysis revealed that MRD-negative patients had significantly better outcomes. Two-year progression-free survival (PFS) ranged from 52.7 to 78 months in MRD-negative patients compared with 16 to 45 months in MRD-positive patients. Similarly, two-year overall survival (OS) was higher in MRD-negative patients, ranging from 78% to 100%, compared with 59% to 96% in MRD-positive patients. At three years, MRD-negative patients had a PFS ranging from 63% to 94%, compared with 38% to 86% in MRD-positive patients.
In a subset of six studies (n=1,119), the odds ratio (OR) for two-year PFS was 4.94 (95% CI, 2.52–9.70) in favor of MRD-negative patients, and the OR for two-year OS was 3.04 (95% CI, 1.43–6.47). These findings highlight that MRD negativity significantly improves survival outcomes.
The authors concluded that MRD negativity is a strong predictor of better prognosis and survival in patients with MM. However, they noted limitations due to variations in study design, induction regimens, and inclusion of retrospective data.
Reference
Iftikhar A, Ali MA, Ismail MS, et al. Impact of MRD status on survival rates in newly diagnosed transplant-eligible multiple myeloma patients: a systematic review and meta-analysis. Abstract #297. Presented at the Twelfth Annual Meeting of the Society of Hematologic Oncology; September 4-7, 2024; Houston, Texas.