Are we ready for an MRD-driven approach in multiple myeloma?

In this issue of Blood, Perrot et al reported preliminary results of the MIDAS study showing that roughly two-thirds of patients with newly diagnosed multiple myeloma (NDMM) can achieve measurable residual disease (MRD) negativity after a quadruplet induction with isatuximab, carfilzomib, lenalidomide, and dexamethasone (IsaKRd). These results represent the premises for the second portion of the study where treatment deintensification (IsaKRd consolidation vs autologous stem-cell transplant [ASCT]) will be tested in MRD- patients and treatment intensification (single vs tandem ASCT) will be evaluated in MRD+ ones.