{"entity":{"id":"mrd-negativity-myeloma","kind":"term","name":"MRD negativity (myeloma, 10⁻⁵ / 10⁻⁶)","aka":[],"tldr":"MRD negativity means no detectable myeloma cell among 100,000 or a million marrow cells. It is the best predictor of long survival and, since 2024, an accepted endpoint for accelerated approval.","summary":"Measured by next-generation flow (EuroFlow) or NGS (clonoSEQ) on bone marrow, increasingly with imaging (PET) confirmation. FDA ODAC voted 12-0 in April 2024 that MRD negativity at 12 months can support accelerated approval. Sustained MRD negativity (≥12 months) is the strongest prognostic marker; MRD-guided de-escalation of maintenance is being tested (DRAMMATIC, MASTER).","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Minimal_residual_disease","links":[{"label":"IMWG consensus criteria for response and MRD assessment (Kumar et al., Lancet Oncology 2016)","url":"https://doi.org/10.1016/S1470-2045(16)30206-6"}],"tags":[],"related":[],"cancers":["multiple-myeloma"],"sections":[],"technologies":["mrd-testing"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["mrd"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-kumar-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"category":"Endpoints"},"route":"/terms/mrd-negativity-myeloma/","neighbours":{"cancer":[{"id":"multiple-myeloma","kind":"cancer","name":"Multiple myeloma","route":"/cancers/multiple-myeloma/"},{"id":"myeloma-transplant-eligible","kind":"cancer","name":"Newly diagnosed multiple myeloma, transplant-eligible","route":"/cancers/myeloma-transplant-eligible/"},{"id":"myeloma-transplant-ineligible","kind":"cancer","name":"Newly diagnosed multiple myeloma, transplant-ineligible","route":"/cancers/myeloma-transplant-ineligible/"},{"id":"myeloma-relapsed-refractory","kind":"cancer","name":"Relapsed or refractory multiple myeloma","route":"/cancers/myeloma-relapsed-refractory/"}],"technology":[{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"term":[{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"}],"paper":[{"id":"paper-cartitude-4-cilta-cel-nejm-2023","kind":"paper","name":"CARTITUDE-4: cilta-cel CAR-T versus standard combinations after one to three prior lines of myeloma therapy","route":"/key-papers/paper-cartitude-4-cilta-cel-nejm-2023/"},{"id":"paper-cepheus-dara-vrd-natmed-2025","kind":"paper","name":"CEPHEUS: daratumumab quadruplet for newly diagnosed myeloma patients not having a transplant, with MRD-negativity as the main endpoint","route":"/key-papers/paper-cepheus-dara-vrd-natmed-2025/"},{"id":"paper-kumar-lancet-oncol","kind":"paper","name":"International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma","route":"/key-papers/paper-kumar-lancet-oncol/"},{"id":"paper-maia-daratumumab-rd-nejm-2019","kind":"paper","name":"MAIA: adding daratumumab to lenalidomide-dexamethasone for older patients with newly diagnosed myeloma who cannot have a transplant","route":"/key-papers/paper-maia-daratumumab-rd-nejm-2019/"},{"id":"paper-perseus-dara-vrd-transplant-nejm-2024","kind":"paper","name":"PERSEUS: daratumumab added to bortezomib-lenalidomide-dexamethasone around autologous transplant in newly diagnosed myeloma","route":"/key-papers/paper-perseus-dara-vrd-transplant-nejm-2024/"}],"trial":[{"id":"perseus","kind":"trial","name":"PERSEUS","route":"/trials/perseus/"}],"idea":[{"id":"idea-mrd-guided-stop-myeloma","kind":"idea","name":"MRD-guided treatment-free intervals in myeloma","route":"/ideas/idea-mrd-guided-stop-myeloma/"}],"person":[{"id":"vincent-rajkumar","kind":"person","name":"S. Vincent Rajkumar","route":"/people/vincent-rajkumar/"},{"id":"shaji-kumar","kind":"person","name":"Shaji K. Kumar","route":"/people/shaji-kumar/"}],"bottleneck":[{"id":"b-dormancy-mrd","kind":"bottleneck","name":"Dormant cells and minimal residual disease","route":"/bottlenecks/b-dormancy-mrd/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"collection":[{"id":"mmrf","kind":"collection","name":"Multiple Myeloma Research Foundation (MMRF)","route":"/collections/mmrf/"}],"drug":[{"id":"clonoseq","kind":"drug","name":"clonoSEQ","route":"/drugs/clonoseq/"}]}}