Characteristics of available MRD assays
| End point . | Assay . | Disadvantage . | Target group(s) . |
|---|---|---|---|
| CR/sCR | Standard technology | Less sensitive | NDMM elderly/frail |
| Benchmark in clinical trial | RRMM | ||
| Widely applicable | |||
| Evidence based | |||
| No extra costs | |||
| No need for central laboratory | |||
| MRD by MFC | Represents immunophenotypic response | Requires processing within 48 h | Transplant-eligible NDMM |
| Sensitivity ≥10−4 | Requires ≥5 × 106 cells | Clinical trials | |
| Standard Euroflow protocol | Cost of assay | ||
| Automated analysis | Less sensitive than NGS | ||
| Available in many centers | |||
| MRD by qPCR | Represents molecular response | Labor intensive | Transplant-eligible NDMM |
| Sensitivity ≥10−5 | Requires ≥106 cells | Clinical trials | |
| Standardized in ALL and other diseases | Applicable in ≤70% of patients | ||
| Widely available | Requires baseline sample | ||
| MRD by VDJ NGS | Sensitivity ≥10−5 | Labor intensive | Transplant-eligible NDMM |
| Commercial product by 1-2 companies | Requires ≥106 cells | Clinical trials | |
| Applicable in ≤90% of patients | |||
| Requires bioinformatics | |||
| Requires baseline sample | |||
| (MRD+)PET-CT | Evaluation of extramedullary disease | Standard not yet defined as in lymphomas | All |
| Widely available | |||
| MRD by CTCs/RNA/DNA | Assay in blood | Requires single-cell NGS | All |
| No sampling error | Not widely available | ||
| Represents whole-body tumor mass | Not standardized |
| End point . | Assay . | Disadvantage . | Target group(s) . |
|---|---|---|---|
| CR/sCR | Standard technology | Less sensitive | NDMM elderly/frail |
| Benchmark in clinical trial | RRMM | ||
| Widely applicable | |||
| Evidence based | |||
| No extra costs | |||
| No need for central laboratory | |||
| MRD by MFC | Represents immunophenotypic response | Requires processing within 48 h | Transplant-eligible NDMM |
| Sensitivity ≥10−4 | Requires ≥5 × 106 cells | Clinical trials | |
| Standard Euroflow protocol | Cost of assay | ||
| Automated analysis | Less sensitive than NGS | ||
| Available in many centers | |||
| MRD by qPCR | Represents molecular response | Labor intensive | Transplant-eligible NDMM |
| Sensitivity ≥10−5 | Requires ≥106 cells | Clinical trials | |
| Standardized in ALL and other diseases | Applicable in ≤70% of patients | ||
| Widely available | Requires baseline sample | ||
| MRD by VDJ NGS | Sensitivity ≥10−5 | Labor intensive | Transplant-eligible NDMM |
| Commercial product by 1-2 companies | Requires ≥106 cells | Clinical trials | |
| Applicable in ≤90% of patients | |||
| Requires bioinformatics | |||
| Requires baseline sample | |||
| (MRD+)PET-CT | Evaluation of extramedullary disease | Standard not yet defined as in lymphomas | All |
| Widely available | |||
| MRD by CTCs/RNA/DNA | Assay in blood | Requires single-cell NGS | All |
| No sampling error | Not widely available | ||
| Represents whole-body tumor mass | Not standardized |
ALL, acute lymphoblastic leukemia; CTCs, circulating tumor cells; MFC, multiparameter flow cytometry; NDMM, newly diagnosed MM; NGS, next-generation sequencing; PET-CT, positron emission tomography–computed tomography; qPCR, quantitative PCR.