Impact of t(11;14) on MRD dynamics in NDMM

Results from a pooled analysis of the MASTER (NCT03224507) and MILESTONE  (NCT04991103) studies in patients with newly diagnosed multiple myeloma (NDMM), treated with quadruplet (QUAD) induction + autologous hematopoietic stem cell transplantation (ASCT), were published in Blood by Bal et al. The analysis evaluated the impact of translocation (t)11;14 on measurable residual disease (MRD) dynamics.

Key data: Among 302 patients included in the analysis, 16% were t(11;14)+ and 84% were t(11;14)−. MRD negativity, at a sensitivity of 10⁻⁵, following induction was 9% in t(11;14)+ and 31% in t(11;14)− patients (p < 0.001), increasing to 36% vs 59% after ASCT (p = 0.004), and to 53% vs 75% at any time on treatment (p = 0.004). Rates of sustained MRD negativity were comparable between groups (38% vs 46%; p = 0.43). Median time to MRD negativity (<10⁻⁵) was longer in t(11;14)+ patients (13.6 months vs 7.7 months; p = 0.002). Four-year progression-free survival (PFS) rates were 90% vs 72% in patients who were t(11;14)+ and t(11;14)−, respectively (p = 0.012).

Key learning: Despite slower MRD clearance, patients with t(11;14)+ NDMM treated with QUAD induction and ASCT experienced comparable sustained MRD negativity to patients with t(11;14)− NDMM and improved PFS, indicating a favorable prognosis.