MRD-negative status prognostic for PFS and OS for patients with multiple myeloma

Minimal residual disease (MRD)-negative status is predictive of progression-free survival (PFS) and overall survival (OS) in patients with multiple myeloma (MM). That’s according to results from the Prognostic Immunophenotyping for Myeloma Response (PRIMeR) Study—the first ancillary study of MRD assessment by next generation flow cytometry in the U.S.

PRIMeR was an ancillary study of the Stem Cell Transplantation for Multiple Myeloma Incorporating Novel Agents (STAMiNA) study. Out of 758 patients enrolled in the STAMiNA study, 437 provided consent and a minimum of one sample for MRD analysis for the PRIMeR study. 

MRD assessment occurred at baseline (BL)/pre-autologous hematopoietic cell transplantation (HCT); pre-maintenance (PM); and one year post-autologous HCT. The study’s primary endpoint: MRD-negative at one year.  

At all measured time points, MRD status was prognostic for PFS and for one year OS. Despite better outcomes and continued maintenance with lenalidomide, patients with MRD-negative MM at one year still experienced disease progression (23% vs. 56% at 38 months after autologous HCT). At 38 months median follow-up, no significant difference was found in PFS or OS, in PRIMeR patients.

Presenting the findings at the 2019 Transplantation & Cellular Therapy (TCT) Meetings of American Society for Transplantation and Cellular Therapy (ASTCT) and CIBMTR®, Theresa Hahn, Ph.D., from Roswell Park Cancer Institute, Buffalo, New York, concluded that, along with other clinical factors, MRD status may be useful when considering additional therapy needs for a patient with MM and future analysis of the results will include five-year follow-up of PFS and OS.