Measurable Residual Disease–Guided Therapy in Newly Diagnosed Myeloma
Aurore Perrot, Jérôme Lambert, Cyrille Hulin, Andrea Pieragostini, Lionel Karlin, Bertrand Arnulf, Philippe Rey, Laurent Garderet, Margaret Macro, Martine Escoffre‐Barbe, Julie Gay, Thomas Chalopin, Romain Gounot, Jean-Marc Schiano, Mohamad Mohty, Xavier Leleu, Salomon Manier, Clara Mariette, Carine Chaleteix, Thorsten Braun, Bernard De Prijck, Hervé Avet‐Loiseau, Jean‐Yves Mary, Jill Corre, Philippe Moreau, Cyrille Touzeau
Abstract
BACKGROUND: Measurable residual disease (MRD) is a major prognostic factor in newly diagnosed multiple myeloma. An assessment of an MRD-guided consolidation strategy in patients who are eligible for autologous stem-cell transplantation (ASCT) may be useful. METHODS: sensitivity before maintenance therapy. RESULTS: sensitivity occurred in 32% in the tandem ASCT group and in 40% in the single ASCT group (adjusted relative risk, 0.82; 95% CI, 0.58 to 1.15; P = 0.31); 15% of the patients in the tandem ASCT group did not undergo a second ASCT. During consolidation, disease progression occurred in 5 patients and death unrelated to disease progression occurred in 2 patients - all were in the Isa-KRd or tandem ASCT groups. No new safety signals were observed. The median follow-up was 16.8 months in the ASCT and Isa-KRd groups and 16.3 months in the tandem ASCT and single ASCT groups. CONCLUSIONS: sensitivity was not significantly higher with tandem ASCT than with single ASCT. (Funded by Intergroupe Francophone du Myélome and others; MIDAS ClinicalTrials.gov number, NCT04934475.).