Utilizing MRD Testing in the Myeloma Space

Gayathri Ravi, MD, assistant professor at University of Alabama, Birmingham, discusses the role minimal residual disease (MRD) plays in decision making and treating patients with hematologic malignancies.

According to Ravi, the use of MRD is becoming more relevant in today's practice, especially in the myeloma space. This is attributed to MRD being a strong prognostic factor.

Experts are working to find MRD-adapted treatment and management can be applied in real-world practice. Ravi notes that it will be important to determine the feasibility of using MRD in academic centers, as well as when involving community partners.

Additionally, there are still questions that need to be answered by research regarding the use of MRD, when to measure patients, how frequently to measure patients, and more.

Transcription:

0:08 | We do know that MRD is a strong prognostic factor. We do know that people who are not able to achieve MRD negativity have early-risk of progression and relapse. At this time, most of the trials have been conducted during treatment time points to measure MRD to look at post-induction therapy, post-transplant, post-consolidation, and periodically during maintenance therapy, mostly in the trial setting and not outside in the real practice.

0:47 | What we do not know is if MRD alone is sufficient to decide on discontinuation of therapy, or should we monitor additional parameters in addition to the regular myeloma labs that we measure? If so, how frequently should we measure that, especially when we decide to take patients off treatment? We do not have data on that, so that is something that is critical, especially if we are looking at MRD-based therapies where we talk about monitoring patients off treatment. Then, we need to know when we need to measure them, how frequently we need to measure them, and what else we need to measure.