What Does MRD-Negative Mean in Multiple Myeloma? Testing, Maintenance & Treatment Decisions

Dr. Tara Gregory, joined by Dr. Peter Forsberg, answers audience questions about MRD (minimal residual disease) testing in multiple myeloma: what the ClonoSEQ test actually measures, how M-spike, light chain, and immunofixation results translate into remission categories (partial remission, VGPR, complete remission, and stringent complete remission), and how MRD-negative status is reshaping treatment decisions. They discuss the ENDURANCE trial data on stopping maintenance therapy after two years of MRD-negativity, why that option currently applies only to standard-risk (not high-risk) patients, whether myeloma relapses more aggressively after stopping treatment, how long MRD-negativity tends to last based on the MASTER trial, and how often patients realistically need to be retested. They close with a candid discussion of when it's okay to stop maintenance therapy for quality-of-life reasons, even without a confirmed MRD-negative result.