Episode 46. Updates in Myeloma MRD with Dr. Ben Derman and Dr. Manni Mohyuddin
Jun 9, 2024
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Dr. Benjamin Derman and Dr. Manni Mohyuddin discuss updates in Minimal Residual Disease (MRD) in multiple myeloma, including the potential use of MRD as a surrogate endpoint for accelerated FDA approval. They explore the benefits and challenges of achieving MRD negativity, advancements in MRD detection technologies, implications of MRD resurgence, and the impact of MRD negativity on treatment decisions and discontinuation. The podcast sheds light on the complexities of utilizing MRD in myeloma treatment strategies.
MRD negativity is a prognostic biomarker in myeloma, guiding treatment modifications for better outcomes.
MRD resurgence kinetics and trials like MRD2STOP inform decisions on maintenance therapy continuation or cessation.
Deep dives
Overview of MRD or Minimal Residual Disease in Multiple Myeloma
Minimal residual disease (MRD) has gained attention in multiple myeloma, with recent advancements discussed in the podcast. MRD negativity correlates positively with better outcomes, serving as a prognostic biomarker and a tool for treatment modification. The significance of individual and trial-level surrogacy of MRD in myeloma is highlighted, showcasing its value as a predictive indicator for patient outcomes.
Challenges and Considerations in Using MRD as a Surrogate Endpoint
The discussion delves into the complexities of using MRD as a surrogate endpoint for accelerated approval in multiple myeloma. Various viewpoints on the timing and implications of MRD resurgence, its prognostic value, and the debate on treatment escalation or de-escalation based on MRD status are explored. Insights from studies like MRT2 stop inform decisions on continuation or cessation of maintenance therapy.
Exciting MRD-Guided Clinical Trials in Progress
Upcoming MRD-guided clinical trials offer promising avenues for personalized treatment approaches in multiple myeloma. Trials like Dramatic, Master 2, and Midas focus on stratifying patients based on MRD status to optimize therapeutic strategies, including the decision to continue or discontinue maintenance therapy. These trials aim to enhance treatment outcomes through tailored interventions aligned with MRD assessment.
Novel Concepts for MRD Assessment and Treatment Strategy
Novel concepts in MRD assessment and treatment strategy, such as exploring MRD-guided cessation of maintenance therapy for select patients, offer innovative approaches for improving outcomes in multiple myeloma. Trials emphasizing MRD negativity as a basis for treatment decisions provide insights into the potential for individualized therapy and the impact on long-term patient management.
In this episode, we dive into updates in Minimal Residual Disease (MRD) in multiple myeloma, along with the FDA ODAC meeting in April 2024 to decide on MRD as a surrogate endpoint for accelerated approval. Our guests are Dr. Benjamin Derman and Dr. Manni Mohyuddin. Here are the key papers we discussed: