Blood: The prognostic significance of negative minimal residual disease in multiple myeloma

Recent treatment advances in multiple myeloma (MM) have nearly doubled patient survival
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As the long-term outcomes of patients with myeloma continue to improve, clinical trials need to extend follow-up to demonstrate the clinical benefit of the investigational drug/regimen

Recently, a large-scale meta-analysis was published in Blood period (PFS)
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We used data from four phase 3 studies (POLLUX, CASTOR, ALCYONE, and MAIA) to evaluate relapsed/refractory multiple myeloma (RRMM) and newly diagnosed multiple myeloma not transplantable (TIE) ( NDMM) patients with minimal residual disease
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Each study has demonstrated that daratumumab-based therapy increases minimal residual disease negativity and reduces the risk of disease progression or death by approximately 50% compared to standard therapy

Group PFS stratified by response and MRD status

The median follow-up time for POLLUX, CASTOR, ALCYONE, and MAIA studies was 54.

PFS stratified by response and MRD status in daratumumab and control groups

Cox proportional hazards models confirmed that minimal residual disease-negative complete or better responses were associated with longer progression-free survival
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Daratumumab-based therapy was associated with more patients achieving minimal residual disease-negative complete or better responses

In conclusion, the findings support the use of minimal residual disease negativity as a predictor of survival in patients with relapsed/refractory multiple myeloma and nontransplantable de novo multiple myeloma

Original source:

Michele Cavo, Jesus San-Miguel, Saad Z.