Minimal Residual Disease (MRD) is a hot topic today in the field of multiple myeloma (MM), in great part because we finally have very active treatment regimens that can bring deep and sustained responses to patients. Measuring MRD refers to counting the number of multiple myeloma cells that remain in a patient after a course of therapy is completed. This measurement is done from a bone marrow aspirate or a vial of blood by counting the number of MM cells present by one of several extremely sensitive methods, which can detect even one MM cell in 1 million total cells. This count can quickly inform the physician of how much disease remains after treatment with a particular therapy, in effect informing of how effective that therapy was in that patient. Measuring MRD in patients after treatment can also help determine how deep their remission is, and may help indicate how long their remission will last and when they might relapse again. This ability to quickly and accurately measure how effective medicines are against MM will be an important step in speeding new drugs to the clinic. In order for doctors to use MRD as a clinical test and a marker of MM disease levels, MRD measurement must first be approved by the FDA.
To facilitate and speed the FDA approval process, the MMRF helped organize, with Memorial Sloan Kettering Cancer Center, a meeting entitled “Advances in Minimal Residual Disease Testing in Myeloma”. The meeting is happening today in NYC. This full day event brings together representatives from the FDA, the NCI, and the biotech/pharma industries as well as key MM opinion leaders, to discuss the latest developments around MRD testing in multiple myeloma, and to decide the next steps needed toward approval by the FDA.
Here are a few words from Dr. C. Ola Landgren, Chief, Myeloma Service Memorial Sloan Kettering Cancer Center, Professor of Medicine at the Weill Cornell Medical College, about today’s meeting:
“I feel we are getting closer and closer to make MRD an endpoint for myeloma drug approval. In one year, we have made such great progress. We have provided lots of original data showing that MRD is a valid endpoint. Soon IMWG guidelines will include MRD. Studies are ongoing with MRD as the endpoint. Technologies and approaches are being harmonized. We have it lined up now and there is still a little work to be done. I’m very happy and excited about the future.”
Stay tuned for more news from this remarkable meeting!
Download Slide Presentations:
Session I
Welcome: “Advances in minimal residual disease testing in myeloma – Presenter: Ola Landgren
New IMWG Response Criteria – Presenter: Shaji Kumar
Minimal Residual Disease assessment in Multiple Myeloma by Next-Generation Sequencing – Presenter: Ken Anderson
NCI-MSK collaboration: a formal MRD meta analysis – Presenter: Ola Landgren
Session II
Single tube 10-color assay for sensitive detection of residual plasma cell neoplasms: MSKCC experience – Presenter: Mikhail Roshal
New CAP requirements to improve MRD testing standardization – Presenter: Michael Linden
Towards detection of minimal residual disease in multiple myeloma through circulating tumour DNA sequence analysis – Presenter: Trevor Pugh
Comprehensive characterization of low abundance MM cells –in Blood and BM – Presenter: Jens Lohr
Lunch Session
Strategies in MRD for MM – Presenters: Ken Anderson & Daniel Auclair
Session III
Ongoing Trials – Presenter: Faith Davies
Next generation trials for MRD – Presenter: Ola Landgren
Session IV
MRD and High Risk Myeloma – Presenter: Gareth Morgan
MRD Implications for High risk Disease – Presenter: Rafael Fonseca
Clonal heterogeneity and MRD testing in multiple myeloma – Presenter: Sham Mailankody
Clonal Heterogeneity and MRD – Presenter: Jonathan Keats
Minimal residual disease in smoldering myeloma – Presenter: Malin Hultcrantz
MRD in the Transition of Smoldering MM to Symptomatic MM – Presenter: Christophe Heuck