The role of minimal residual disease testing in myeloma treatment selection and drug development: Current value and future applications Journal Article


Authors: Anderson, K. C.; Auclair, D.; Kelloff, G. J.; Sigman, C. C.; Avet-Loiseau, H.; Farrell, A. T.; Gormley, N. J.; Kumar, S. K.; Landgren, O.; Munshi, N. C.; Cavo, M.; Davies, F. E.; Di Bacco, A.; Dickey, J. S.; Gutman, S. I.; Higley, H. R.; Hussein, M. A.; Jessup, J. M.; Kirsch, I. R.; Little, R. F.; Loberg, R. D.; Lohr, J. G.; Mukundan, L.; Omel, J. L.; Pugh, T. J.; Reaman, G. H.; Robbins, M. D.; Sasser, A. K.; Valente, N.; Zamagni, E.
Article Title: The role of minimal residual disease testing in myeloma treatment selection and drug development: Current value and future applications
Abstract: Treatment of myeloma has benefited from the introduction of more effective and better tolerated agents, improvements in supportive care, better understanding of disease biology, revision of diagnostic criteria, and new sensitive and specific tools for disease prognostication and management. Assessment of minimal residual disease (MRD) in response to therapy is one of these tools, as longer progression-free survival (PFS) is seen consistently among patients who have achieved MRD negativity. Current therapies lead to unprecedented frequency and depth of response, and next-generation flow and sequencing methods to measure MRD in bone marrow are in use and being developed with sensitivities in the range of 105 to 106 cells. These technologies may be combined with functional imaging to detect MRD outside of bone marrow. Moreover, immune profiling methods are being developed to better understand the immune environment in myeloma and response to immunomodulatory agents while methods for molecular profiling of myeloma cells and circulating DNA in blood are also emerging. With the continued development and standardization of these methodologies, MRD has high potential for use in gaining new drug approvals in myeloma. The FDA has outlined two pathways by which MRD could be qualified as a surrogate endpoint for clinical studies directed at obtaining accelerated approval for new myeloma drugs. Most importantly, better understanding of MRD should also contribute to better treatment monitoring. Potentially, MRD status could be used as a prognostic factor for making treatment decisions and for informing timing of therapeutic interventions. ©2017 AACR.
Journal Title: Clinical Cancer Research
Volume: 23
Issue: 15
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2017-08-01
Start Page: 3980
End Page: 3993
Language: English
DOI: 10.1158/1078-0432.ccr-16-2895
PROVIDER: scopus
PUBMED: 28428191
DOI/URL:
Notes: Article -- Export Date: 5 September 2017 -- Source: Scopus
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  1. Carl Ola Landgren
    188 Landgren