Measurable Residual Disease Testing in Multiple Myeloma Routine Clinical Practice: A Modified Delphi Study
Karthik Ramasamy1, Hervé Avet-Loiseau2, Cecilie Hveding Blimark3
1Oxford University Hospitals NHS Foundation Trust, Radcliffe Department of Medicine, Oxford University, Oxford, United Kingdom.
Hemasphere
|September 4, 2023
Summary
Measurable residual disease (MRD) testing is recommended for multiple myeloma (MM) patients achieving complete response, especially post-transplant. However, consensus on using MRD status for treatment decisions remains elusive.
Area of Science:
- Hematology
- Oncology
- Clinical Trial Design
Background:
- Multiple myeloma (MM) management relies on accurate treatment response assessment.
- Measurable residual disease (MRD) testing is emerging as a key biomarker in MM.
- Establishing expert consensus on MRD utility is crucial for clinical practice and research.
Purpose of the Study:
- To achieve consensus on the utility of measurable residual disease (MRD) testing in multiple myeloma (MM).
- To inform disease management strategies and the design of future clinical trials in MM.
- To identify areas of agreement and disagreement among European hematological oncologists regarding MRD testing.
Main Methods:
- A modified Delphi approach was employed, involving two iterative rounds of surveys.
- An expert panel of 61 hematological oncologists from 14 European countries participated.
- Consensus was defined as 75% agreement or disagreement on individual survey questions.
Main Results:
- Consensus was reached that MRD testing is recommended for newly diagnosed or relapsed MM patients achieving complete response (CR) or better, particularly post-transplantation.
- Experts recommended MRD testing in transplant-ineligible patients aged ≤70 years who are in CR.
- Specific recommendations were made for MRD and PET/CT assessment timing and frequency in CR patients, but no consensus emerged on treatment decisions based on MRD status.
Conclusions:
- MRD testing is considered an important component of clinical management for multiple myeloma.
- Further research and data are needed to clarify the role of MRD in guiding MM treatment decisions.
- The study highlights key areas of consensus and non-consensus for MRD implementation in MM care.
