MRD-negative patients with newly diagnosed multiple myeloma (NDMM) achieved significantly better progression-free and overall survival compared with those who were MRD positive in a substudy of a European Myeloma Network phase III clinical trial. After a median follow-up of 75 months, 5-year progression-free survival (PFS) was 66% for MRD-negative patients versus 31% for MRD-positive patients, while 5-year overall survival (OS) was 86% versus 69%, respectively. The findings were published in June in the Blood Cancer Journal.
The EMN02/HO95 trial enrolled 1,503 previously untreated transplant-eligible patients aged 65 years or under. MRD was evaluated by multiparameter flow cytometry (MFC) in 321 patients with a suspected complete response before the initiation of lenalidomide maintenance therapy and at 6-month intervals during maintenance therapy until progressive disease occurred. Among patients who received 1 year of lenalidomide maintenance therapy, 42% of those who were MRD positive pre-maintenance became MRD negative.
“MRD by MFC is a strong prognostic factor” for both PFS and OS, wrote the authors, who were led by Stefana Oliva, of the University of Turin in Italy and Davine Hofste op Bruinink of the Erasmus MC Cancer Institute in Rotterdam, the Netherlands. “Lenalidomide maintenance further improved MRD-negativity rate.”
- Oliva S, Bruinink DHO, Rihova L, et al. Minimal residual disease assessment by multiparameter flow cytometry in transplant-eligible myeloma in the EMN02/HOVON 95 MM trial. Blood Cancer J. 2021;11(6):106. Published 2021 Jun 3. doi:10.1038/s41408-021-00498-0
- Cavo M, Gay F, Beksac M, et al. Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/HO95): a multicentre, randomised, open-label, phase 3 study [published correction appears in Lancet Haematol. 2020 Jun;7(6):e443] [published correction appears in Lancet Haematol. 2020 Nov;7(11):e785]. Lancet Haematol. 2020;7(6):e456-e468. doi:10.1016/S2352-3026(20)30099-5