Ankit Kansagra, Medical Oncologist and Associate Vice President of Oncology Integration , shared OncLive.com’s post on X, adding:
“Annual MRD testing is now in the NCCN myeloma guidelines.
Recent version 1.2027 lays out bone marrow MRD by NGS (FDA-approved assay) or multicolor flow across the whole course of treatment: after induction, at 100 days or 3 months after transplant or CAR-T, after relapse therapy or a major Tx change, and at regular intervals during maintenance or surveillance. 10^-6 is preferred, 10^-5 is the minimum.
A baseline clonotype sample goes in once, at diagnosis or before Tx.
And the line that will change clinic workflow: ‘annual testing is the general recommendation.’
Quick thoughts
- Sustained MRD negativity tells us far more than a single negative result, and you can’t know it’s sustained without serial testing
- The baseline clonotype sample is the step most likely to get missed. If nobody sends it at diagnosis, NGS tracking gets much harder later, often waiting on a relapse sample. That’s an operational fix: build it into the diagnostic marrow order set
- For EMD, PCL and oligo- or non-secretory disease, MRD supplements imaging (and circulating plasma cells in PCL) rather than replacing it. Good that this is spelled out
- A marrow every year is real burden for pts, and for practices that don’t have a procedure slot or a payer who agrees
- The bigger gap is translational. We have a schedule for measuring MRD, but outside trials we still don’t have validated rules for what to do with the result: when to stop maintenance, when to escalate on MRD resurfacing
An important step in right direction, but much more to do for implementing in beyond academic practices.”
Quoting OncLive.com’s post:
“Updated NCCN guidelines now feature additional MRD recommendations in multiple myeloma, moving the field towards more individualized approaches.
Read more here Updated NCCN Guidelines Feature Additional MRD Recommendations in Multiple Myeloma.”
Other articles about myeloma on OncoDaily.