Minimal Residual Disease Testing Infrastructure in Multiple Myeloma: Guidance for Clinical Trial and Routine Practice Use in Canada

Measurable/minimal residual disease (MRD) is 1 of the most powerful prognostic factors for progression-free survival and overall survival in multiple myeloma (MM) and may guide therapeutic approaches. Here, we provide an overview of the current state of MRD testing in MM in Canada, highlighting its current use, approaches, and barriers. Furthermore, we discuss the available MRD assays and address questions on their appropriateness for routine practice and clinical trials. We also provide insights into timepoints for MRD testing and the relevance of achieving durable MRD negativity. The consensus recommendations herein were agreed upon by Canadian hematologists practicing at academic cancer centers and community cancer centers, clinical trial investigators, laboratory personnel, MM patients, and took into consideration the Canadian therapeutic landscape and the impact of anticipated regulatory approvals.