Study Confirms Association Between MRD Status and Survival for Patients With Multiple Myeloma

A study published in JAMA Oncology found that for patients with newly diagnosed multiple myeloma (MM), a negative minimal residual disease (MRD) status was associated with improved overall survival (OS).

Nikhil C. Munshi, MD, of the Dana-Farber Cancer Institute and Harvard Medical School in Boston, Massachusetts, and authors conducted a literature review of Medline articles published between January 1990 and January 2016. Fourteen studies (n=1,273) provided data on the relationship between MRD and progression-free survival (PFS) and 12 studies (n=1,100) provided data on MRD and OS.

An MRD-negative status was associated with significantly higher rates of overall PFS (hazard ratio [HR] = 0.41; 95% CI 0.36-0.48; p<0.001) and OS (HR=0.57; 95% CI 0.46-0.71; p<0 .001). The authors assessed the heterogeneity of the studies and found no significant differences with regard to PFS and OS.

Five studies with a PFS endpoint and six studies reporting OS also reported results specifically for patients who had achieved conventional complete response (CR): 574 patients in the PFS studies and 616 in the OS studies. Rates of PFS (HR=0.44; 95% CI 0.34-0.56; p<0.001) and OS (HR=0.47; 95% CI 0.33-0.67; p<0.001) were also significantly higher in studies specifically looking at patients who achieved CR.

“These findings provide quantitative evidence to support the integration of MRD assessment as an endpoint in clinical trials of MM,” the authors concluded.

Sources: Munshi NC, Avet-Loiseau H, Rawstron AC, et al. Association of minimal residual disease with superior survival outcomes in patients with multiple myeloma: A meta-analysis. JAMA Oncol. 2016 September 15. [Epub ahead of print]; Physician’s Briefing, September 16, 2016.