Hello, my name is Ross Firestone. I'm a fellow at Memorial Sloan Kettering Cancer Center. At this ASH, we presented our work trying to better understand the behavior of MRD status in myeloma patients after they've completed their upfront therapy and have now transitioned to maintenance therapy on lenalidomide.
We've known for a while that the patients who achieve that MRD negative status tend to do better than the patients who don't achieve that. And that's why we're trying to use different therapies to improve patients' ability to get to that MRD negative status.
But what we wanted to look at was whether or not changes to a patient's MRD status are meaningful in the context of their disease course. So what we did is we ran a clinical trial of over 100 patients who were on lenalidomide maintenance. We had a bone marrow biopsy every single year to monitor changes to their MRD status.
And what we found is while some of the patients who achieved MRD negativity do convert to MRD positive status, most of those patients actually continue to do quite well on lenalidomide maintenance, and can continue to have long remissions while on that therapy, even though they've lost that MRD negativity.
What we're now looking to do is sort of look at patients' immune systems to see if they can give us a little bit more information about what's going on with their disease in that maintenance phase.
One other thing we've noticed is that lots of people on our study who start MRD positive actually convert to MRD negative. And these patients tend to do very well as well. Over the course of our trial, we've seen very few patients for whom that happened who then ultimately had disease progression in a short time afterward.
What we're trying to do now is sort of augment the standard MRD tools that we use in clinic with a better understanding of our patients' immune systems and sort of how that plays into their disease, and whether we can use it to predict how long the patient will stay in remission.
Components of a patient's immune system are typically very good at sensing either aggressive disease biology or levels of disease that we can't detect with a standard MRD-based tool. And so we're looking at a certain component of the immune system in order to see if it does a better job at detecting residual disease than our needle would during a bone marrow biopsy.
All of the tests that we've done, the immune system tests, have all been done on the peripheral blood, just like a standard blood test. We're trying to also develop all these tests or a minimally invasive method, to try to potentially find a way that we can reduce the number of bone marrow biopsies that our patients get.
HealthTree • December 27, 2024