MRD Assessment in Multiple Myeloma

Tanika Pittman, APRN, explains how minimal residual disease (MRD) assessment can be used to evaluate treatment response in multiple myeloma, emphasizing the importance of communicating the concept in clear, patient-friendly terms. She describes MRD testing as a more sensitive approach for identifying residual disease that may not be detected through conventional response assessments, using the analogy of looking more closely for remaining “dust and dirt” after a room appears clean. Tanika stresses that MRD negativity means disease is not detectable at the sensitivity level of the specific test and should not be interpreted as proof of cure. She references the deeper MRD responses observed in PERSEUS and CEPHEUS with daratumumab-containing therapy and highlights the importance of sustained MRD negativity, noting that repeated negative assessments over time provide additional information about response durability. The discussion also addresses how APPs can help patients interpret MRD results and manage anxiety associated with MRD-positive findings despite otherwise favorable disease assessments. Tanika emphasizes that MRD is an important measure of response but should not be viewed as a stand-alone trigger for changing therapy outside the broader clinical context. Jill adds that, in current practice, MRD does not independently determine treatment duration, although patients increasingly request MRD testing and may bring their results into treatment discussions.