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MRD negativity and outcomes
Based on data evaluated in a meta-analysis of a large cohort of patients with MM (44 studies with PFS data from 8098 patients and 23 studies with OS data from 4297 patients), the prognostic value of MRD negativity is maintained across factors including disease setting and cytogenetic risk profile
Association of MRD negativity and PFS in patients by disease setting
In patients with NDMM who were transplant eligible
Association of MRD negativity with survival in various subgroups of patients with MM
PFS
Figures adapted with permission from Munshi NC, et al. Blood Adv. 2020;4(23):5988-5999.
*P vs MRD positive; †MRD sensitivity thresholds at 10−4, 10−5, and 10−6 were defined as 1 MM cell per 10,000, 100,000, and 1,000,000 nucleated cells, respectively; ‡Genetic abnormalities reported in high-risk patients in this meta-analysis were predominantly defined as the presence of t(4,14), t(14,16), and/or del(17p). §Standard risk was defined as the absence of genetic abnormalities seen in high-risk patients; ¶Only includes studies with MRD sensitivity thresholds at 10−5 and 10−6 – in studies including 10−4, 10−5, and 10−6 MRD sensitivity thresholds, the HR estimates for PFS and OS were 0.41 (95% CI, 0.36–0.46) and 0.49 (95% CI, 0.42–0.57), respectively; **Includes studies that reported immunophenotypic CR, stringent CR, or near CR; ††Does not overlap with CR; ‡‡MRD assessed at 100 days post-ASCT; §§MRD assessed at 12 months after start of maintenance therapy.
ASCT, autologous stem cell transplant; CI, confidence interval; CR, complete response; HR, hazard ratio; MFC, multiparameter (multicolour) flow cytometry; MM, multiple myeloma; MRD, minimal residual disease; NDMM, newly diagnosed multiple myeloma; NGF, next-generation flow cytometry; NGS, next-generation sequencing; OS, overall survival; PCR, polymerase chain reaction; PFS, progression-free survival; R/R, relapsed/refractory; RRMM, relapsed/refractory multiple myeloma; VGPR, very good partial response.
Munshi NC, et al. Blood Adv. 2020;4(23):5988-5999.
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