Shim Kevin Guanwen, Fonseca Rafael
Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ 85054, USA.
Cancers (Basel). 2024 Sep 27;16(19):3288. doi: 10.3390/cancers16193288.
Several novel T-cell-based therapies have recently become available for multiple myeloma (MM). These T-cell redirecting therapies (TRTs) include chimeric antigen receptor T-cells (CAR-T) and bispecific antibodies (BiAbs). In both clinical trial and real-world data, these therapies have demonstrated high rates of deep clinical response, and some are now approved for second-line treatment for relapsed MM. The deep and sustained clinical responses these therapies are capable of inducing will require sophisticated response monitoring to provide meaningful information for patient care. Obtaining measurable residual disease (MRD) negativity has been validated as an independent positive prognostic marker for progression-free survival (PFS) and overall survival (OS) in both newly diagnosed and relapsed refractory patients with multiple myeloma. Assessment for MRD negativity was performed in all of the trials for FDA-approved TRT. Here, we summarize pertinent data for MRD assessment following TRT in MM and provide a rationale and structured framework for conducting MRD testing post TRT.
最近，几种新型的基于T细胞的疗法已可用于治疗多发性骨髓瘤（MM）。这些T细胞重定向疗法（TRT）包括嵌合抗原受体T细胞（CAR-T）和双特异性抗体（BiAb）。在临床试验和真实世界数据中，这些疗法均显示出较高的深度临床缓解率，其中一些现已被批准用于复发MM的二线治疗。这些疗法能够诱导的深度和持续临床缓解将需要精密的缓解监测，以便为患者护理提供有意义的信息。在新诊断和复发难治性多发性骨髓瘤患者中，获得可测量的残留疾病（MRD）阴性已被确认为无进展生存期（PFS）和总生存期（OS）的独立阳性预后标志物。FDA批准的TRT的所有试验均进行了MRD阴性评估。在此，我们总结了MM中TRT后MRD评估的相关数据，并为TRT后进行MRD检测提供了理论依据和结构化框架。
