MIDAS: MRD-driven strategy after Isa-KRd induction in ND ASCT-eligible MM

The Multiple Myeloma Hub spoke with Paul Richardson, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, Massachusetts, US. We asked about the clinical implications of findings from the phase III MIDAS trial (NCT04934475), which evaluated a measurable residual disease (MRD)-driven consolidation and maintenance strategy after induction with isatuximab + carfilzomib + lenalidomide + dexamethasone (Isa-KRd) in patients aged less than 66 years with newly diagnosed (ND), autologous stem-cell transplantation (ASCT)-eligible multiple myeloma (MM) (N = 791).

The primary end point of the MIDAS trial was measurable residual disease (MRD)-negative status at 10−6 sensitivity before maintenance therapy. An additional aim was to evaluate the benefit of high-dose melphalan with ASCT (the current standard care) compared with Isa-KRd alone in patients who were MRD-negative at 10−5 sensitivity post induction.

During this interview, Richardson discussed findings from the MIDAS trial, published by Perrot el al. in Blood and NEJM, and presented at the 2025 American Society of Clinical Oncology Annual Meeting.

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