Professor Jesus San Miguel (University Hospital of Salamanca, Salamanca, Spain) outlines how the role of minimal residual disease (MRD) negativity has evolved to become part of the central narrative of how multiple myeloma is treated.
In the 1980s a cure in multiple myeloma was considered unattainable due to the small proportion of patients achieving a complete response.
However, with the introduction of new agents the landscape has changed.
This movement led to the International Myeloma Working Group recently publishing a consensus criteria for response and minimal residual disease assessment in multiple myeloma.
In this review several aspects of disease response assessment are clarified, as well as endpoints for clinical trials and future directions.
Professor San Miguel adds that while the concept of MRD is usually associated with depth of treatment response in multiple myeloma, there could be growing utility around measuring treatment efficacy with long term follow up, as seen in other diseases.
The impact that MRD negativity has on patients is then discussed, with clear associations between patients being MRD negative and a positive response.
Whilst questions remain, the potential of MRD negativity being a surrogate marker for cure in multiple myeloma is a distinct possibility.
This programme has been supported by an unrestricted educational grant from Janssen Pharmaceuticals (A Johnson & Johnson Company).