title: International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma.
abstract: Treatment of multiple myeloma has substantially changed over the past decade with the introduction of several classes of new effective drugs that have greatly improved the rates and depth of response. Response criteria in multiple myeloma were developed to use serum and urine assessment of monoclonal proteins and bone marrow assessment (which is relatively insensitive). Given the high rates of complete response seen in patients with multiple myeloma with new treatment approaches, new response categories need to be defined that can identify responses that are deeper than those conventionally defined as complete response. Recent attempts have focused on the identification of residual tumour cells in the bone marrow using flow cytometry or gene sequencing. Furthermore, sensitive imaging techniques can be used to detect the presence of residual disease outside of the bone marrow. Combining these new methods, the International Myeloma Working Group has defined new response categories of minimal residual disease negativity, with or without imaging-based absence of extramedullary disease, to allow uniform reporting within and outside clinical trials. In this Review, we clarify several aspects of disease response assessment, along with endpoints for clinical trials, and highlight future directions for disease response assessments.
authors: Division of Hematology, Mayo Clinic, Rochester, MN, USA. Electronic address: kumar.shaji@mayo.edu.
authors: Shaji
authors: S
authors: Kumar
authors: Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Pamplona, Spain.
authors: Bruno
authors: B
authors: Paiva
authors: Dana-Farber Cancer Institute, Boston, MA, USA.
authors: Kenneth C
authors: KC
authors: Anderson
authors: Cedars-Sinai Comprehensive Cancer Center, Los Angeles, CA, USA.
authors: Brian
authors: B
authors: Durie
authors: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Ola
authors: O
authors: Landgren
authors: University Hospital, Nantes, France.
authors: Philippe
authors: P
authors: Moreau
authors: Dana-Farber Cancer Institute, Boston, MA, USA.
authors: Nikhil
authors: N
authors: Munshi
authors: Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA.
authors: Sagar
authors: S
authors: Lonial
authors: Hospital Clinic, Barcelona, Spain.
authors: Joan
authors: J
authors: Bladé
authors: University Hospital of Salamanca/IBSAL, Salamanca, Spain.
authors: Maria-Victoria
authors: MV
authors: Mateos
authors: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors: Meletios
authors: M
authors: Dimopoulos
authors: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors: Efstathios
authors: E
authors: Kastritis
authors: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy; Mount Sinai Cancer Institute, New York, NY, USA.
authors: Mario
authors: M
authors: Boccadoro
authors: MD Anderson Comprehensive Cancer Center, Houston, TX, USA.
authors: Robert
authors: R
authors: Orlowski
authors: Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
authors: Hartmut
authors: H
authors: Goldschmidt
authors: The Alfred Hospital, Melbourne, VIC, Australia.
authors: Andrew
authors: A
authors: Spencer
authors: Chang Zheng Hospital, Shanghai, China.
authors: Jian
authors: J
authors: Hou
authors: National University Health System, Singapore.
authors: Wee Joo
authors: WJ
authors: Chng
authors: Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.
authors: Saad Z
authors: SZ
authors: Usmani
authors: Seragnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors: Elena
authors: E
authors: Zamagni
authors: Tokai Central Hospital, Kakamigahara, Japan.
authors: Kazuyuki
authors: K
authors: Shimizu
authors: Mount Sinai Cancer Institute, New York, NY, USA.
authors: Sundar
authors: S
authors: Jagannath
authors: Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
authors: Hans E
authors: HE
authors: Johnsen
authors: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors: Evangelos
authors: E
authors: Terpos
authors: Dalhousie University Medical School, Dalhousie, Nova Scotia, Canada.
authors: Anthony
authors: A
authors: Reiman
authors: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors: Robert A
authors: RA
authors: Kyle
authors: Erasmus Medical Center, Rotterdam, Netherlands.
authors: Pieter
authors: P
authors: Sonneveld
authors: Dana-Farber Cancer Institute, Boston, MA, USA.
authors: Paul G
authors: PG
authors: Richardson
authors: Roswell Park Cancer Institute, Buffalo, NY, USA.
authors: Philip
authors: P
authors: McCarthy
authors: Wilhelminenspital Der Stat Wien, Vienna, Austria.
authors: Heinz
authors: H
authors: Ludwig
authors: Beijing Chaoyang Hospital, Beijing, China.
authors: Wenming
authors: W
authors: Chen
authors: Seragnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors: Michele
authors: M
authors: Cavo
authors: University Hospital, Nantes, France.
authors: Jean-Luc
authors: JL
authors: Harousseau
authors: Columbia University, New York, NY, USA.
authors: Suzanne
authors: S
authors: Lentzsch
authors: Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
authors: Jens
authors: J
authors: Hillengass
authors: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy.
authors: Antonio
authors: A
authors: Palumbo
authors: University Hospital of Salamanca/IBSAL, Salamanca, Spain.
authors: Alberto
authors: A
authors: Orfao
authors: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors: S Vincent
authors: SV
authors: Rajkumar
authors: Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Pamplona, Spain.
authors: Jesus San
authors: JS
authors: Miguel
authors: University of Toulouse, Toulouse, France.
authors: Herve
authors: H
authors: Avet-Loiseau
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy*; D018365:Neoplasm, Residual / Q000139:chemically induced / Q000175:diagnosis*; D017410:Practice Guidelines as Topic / Q000592:standards*