Dr Mohamad Mohty talks to ecancertv at IMW 2013 on Minimal Residual Disease (MRD) in Multiple Myeloma (MM) as an important indicator of complete response but can be difficult to measure. A number of new surrogate markers provide more sensitive methods of assessing MRD, and can predict patient outcomes and guiding therapeutic decisions. Multiparameter flow cytometry (MFC) is particularly relevant for use in current clinical practice. A number of new imaging techniques are also available for assessing both extramedullary and intramedullary disease.
A number of monoclonal antibodies have been investigated in MM, including elotuzumab and daratumumab. The latter has just received fast track FDA designation this month.
There has been a debate regarding whether or not autologous stem cell transplant (ASCT) should be considered as an upfront therapy in transplant eligible patients or, in light of the strong efficacy data for the thalidomide, bortezomib and lenalidomide, should be reserved for later in the course of the disease. The introduction of carfilzomib and pomalidomide could further influence therapy choices in the future.
The treatment of MM has evolved dramatically in the last 15 years, with the introduction of many new therapies and regimens. In the future, i may be possible to anticipate that MM could be viewed as somewhere between a chronic disease and a curable disease within a subset of patients.
This programme has been supported by an unrestricted educational grant from Janssen Pharmaceutica (A Johnson & Johnson Company).