18th International Myeloma Workshop

MRD-guided therapy debate

Prof Ola Landgren - University of Miami, Miami, USA

Hi, I’m Ola Landgren, I’m Professor of Medicine and chief of the myeloma programme and the experimental therapeutics programme at Sylvester Comprehensive Cancer Center at the University of Miami. I’m invited to the International Myeloma Workshop 2021 that is hybrid in Vienna and virtually to give a talk at the debate session. My talk is focussing on MRD-guided therapy in multiple myeloma.

At this time there are no trials that definitively have proven this to be the way to do it. Looking at other disease areas there is precedence that you can use MRD to guide therapy. If patients turn MRD negative you can step down on the intensity of the treatment; if the MRD goes from negative to positive that would trigger relapse therapy. For example, in chronic myeloid leukaemia you would see that the therapy would change if you see a rise in the MRD or the molecular relapse.

So the debate this year that I’m part of focuses on this very topic and I was given the role to argue for no. So my focus is to lift up the fact that there is not yet any data but I do think the field is moving forward. I do think and I do hope and I believe that soon we will have MRD-guided therapy but I will not tell my colleague who argues for yes that’s my opinion. So I will stick to the no this year.