Bravo-Pérez Carlos, Sola María, Teruel-Montoya Raúl, García-Malo María Dolores, Ortuño Francisco José, Vicente Vicente, de Arriba Felipe, Jerez Andrés
Hematology and Medical Oncology Department, University Hospital Morales Meseguer, IMIB, 30003 Murcia, Spain.
CB15/00055-CIBERER, 30003 Murcia, Spain.
Cancers (Basel). 2021 Aug 27;13(17):4332. doi: 10.3390/cancers13174332.
The game-changing outcome effect, due to the generalized use of novel agents in MM, has cre-ated a paradigm shift. Achieving frequent deep responses has placed MM among those neoplasms where the rationale for assessing MRD is fulfilled. However, its implementation in MM has raised specific questions: how might we weight standard measures against deep MRD in the emerging CAR-T setting? Which high sensitivity method to choose? Are current response criteria still useful? In this work, we address lessons learned from the use of MRD in other neoplasms, the steps followed for the harmonization of current methods for comprehensively measuring MRD, and the challenges that new therapies and concepts pose in the MM clinical field.
由于新型药物在多发性骨髓瘤(MM)中的广泛应用,具有改变游戏规则意义的疗效效应引发了一场范式转变。实现频繁的深度缓解使MM成为符合评估微小残留病(MRD)基本原理的肿瘤类型之一。然而,其在MM中的应用引发了一些具体问题:在新兴的嵌合抗原受体T细胞(CAR-T)治疗背景下,我们应如何权衡标准测量指标与深度MRD?应选择哪种高灵敏度方法?当前的缓解标准是否仍然有用?在这项工作中,我们阐述了从其他肿瘤中使用MRD所吸取的经验教训、为统一当前全面测量MRD的方法所采取的步骤,以及新疗法和新概念在MM临床领域带来的挑战。