Dr Elisabet Manasanch Outlines Potential of MRD Testing for Treatment Decision Making

March 20, 2020

Right now, it's not really used for decision treatment in most centers, but there are a lot of studies that have started this year or starting next year that have MRD as an endpoint so we will see, said Elisabet Manasanch, MD, assistant professor in the Department of Lymphoma/Myeloma and Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center.

Right now, it's not really used for decision treatment in most centers, but there are a lot of studies that have started this year or starting next year that have MRD as an endpoint so we will see, said Elisabet Manasanch, MD, assistant professor in the Department of Lymphoma/Myeloma and Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center.

Transcript

MRD is not really being used currently for treatment decision making—might it be in the future? What might that look like in practice?

So right now, it's not really used for decision treatment in most centers. There are some centers that may actually stop treatment if a patient has been negative for a long time and there are maintenance therapy. So, there are some people that are saying that. I don't know that there is enough evidence to do that right now. So, I think that most physicians, myeloma experts are saying that we're not really changing therapy, either or right now. There are a lot of studies that have started this year or starting next year that have MRD as an endpoint of the study, and that changed therapy based on what the MRD is.

So, I think that in the next 2 to 3 years, we may be able to come and say, “Okay, if you're negative and you've been negative for 5 years after your treatment, you can stop.” Because we've shot a study showing that if you've been negative for 5 years, or 10 years, or whatever, that this is very unlikely that your myeloma will come back. So, we need something like that. Then there are studies where if you're MRD negative and you turn to positive they treat you. So, we'll see how well those people do versus the ones that we just keep watching until they have a relapse in the sense that we see melanoma pertinent in the blood, and so on. So, we will know this for sure because there are already studies that are ongoing or plan to start very shortly.