Clinical Trial Aims to Unravel Genetic Markers of MRD in Multiple Myeloma Patients

The Multiple Myeloma Research Foundation (MMRF) and the Memorial Sloan Kettering Cancer Center  are collaborating to launch a new clinical trial studying minimal residual disease (MRD) in multiple myeloma (MM) patients.

The trial, titled “Carfilzomib, Lenalidomide, Dexamethasone in Newly-Diagnosed Multiple Myeloma: A Translational MRD Study,” is expected to begin before the end of the year and will include newly-diagnosed MM patients, independent of their eligibility for an autologous stem cell transplant.

Researchers will use therapy that includes more than one chemotherapy drug, with genetic sequencing techniques, to find factors that may promote a positive outcome in patients with MM. The efficacy of these factors will be tested by evaluating the MRD.

Despite the ability of many myeloma treatments to induce cancer remission, patients often relapse due to the presence of a small amount of cancer cells that remain after treatment, which researchers have designated MRD.

This led researchers to suggest that the measurement of these cells could provide a better indication of the effectiveness of cancer therapies. In fact, recent work has shown that MRD is better at predicting survival than the presence of complete response – the lower the number of cancer cells left, the better the patient’s outcome – suggesting that MRD-negativity should be used as an endpoint in myeloma clinical trials.

“The goals are to reach a sustained MRD negativity in as many patients as possible, and to understand mechanisms of MRD in those who have residual disease so we can eradicate the last tumor cells,” C. Ola Landgren, MD, chief of the Myeloma Service at Memorial Sloan-Kettering Cancer Center in New York City and a specialist in the field of MRD testing in multiple myeloma, said in a press release.

Because MRD measurement provides a faster and more accurate assessment of treatment effectiveness, if approved by the U.S. Food and Drug Administration (FDA), it can be used to determine sooner than ever before which patients should continue therapy or should start receiving other treatment approaches.

This new trial will identify potential genomic markers that can predict patients’ MRD status, and thus their clinical outcomes.

“Based on ongoing genomics studies advanced by the MMRF, we know that multiple myeloma is genetically heterogeneous across patients,” said Daniel Auclair, PhD, vice president of research at MMRF. “This new collaboration will further define individual patients’ genetic fingerprints of multiple myeloma at diagnosis and track myeloma subclones during therapy, representing another step toward advancing Precision Medicine for all myeloma patients.”