The use of next-generation sequencing (NGS) and next-generation flow (NGF) for assessing minimal residual disease (MRD) in multiple myeloma (MM) was compared in a recent publication in Blood Cancer Journal (2020;10[10]:108. doi:10.1038/s41408-020-00377-0).
MRD in MM can be studied using molecular techniques such as NGF and NGS. NGF is approved by the International Myeloma Working Group to detect complete response and is more sensitive than previous flow protocols. However, it requires a high level of expertise to use and a high-quality sample processed quickly. NGS use to detect MRD in MM is less studied.
“We aimed at validating the potential applicability and usefulness of a new NGS methodology for the diagnosis and MRD detection in MM patients,” explained the study authors.
Patients were selected for the study based on 3 criteria. First, they must be newly diagnosed with MM, transplant-candidate patients included in the Spanish GEM2012 clinical trial, whose clonotypic rearrangements were previously identified. Second, patients must have had a NGF evaluation performed at diagnosis and follow-up per protocol. Third, patients must have enough amount of gDNA available for MRD studies.
Bone marrow samples were collected from each patient and gDNA was isolated from the samples. MRD was evaluated 3 months after transplantation in 106 MM patients using a commercial NGS panel, LymphoTrack®. Results were compared with NGF.
A limitation for NGS included the use of bone marrow sampling, turnaround time, and a high number of cells required to reach sensitivity. However, NGS is easier to use and semi-automated. When compared with NGF, a high correlation was found (R2 = 0.905). Similar results were demonstrated for all comparisons, including 3-year progression-free survival rates and overall survival.
“In summary, our results support the use of the LymphoTrack® strategy to detect and evaluate MRD in MM patients, with excellent applicability and comparable results to NGF,” concluded the study authors. “Altogether, these findings reinforce the use of MRD assessment as an endpoint in MM clinical trials and underline the need of standardization and quality assessment in future studies for all MRD approaches in MM.”—Lisa Kuhns
