Contextualizing MRD Negativity and PFS Across Treatment Regimens in Relapsed/Refractory Multiple Myeloma

In this segment, Dr. Joseph Mikhael and Dr. Scott Goldsmith discuss how to interpret MRD negativity and progression-free survival (PFS) findings from the EXCALIBER-RRMM trial alongside results from established triplet regimens in relapsed/refractory multiple myeloma. Dr. Mikhael highlights the MRD negativity rates reported with traditional combinations, including daratumumab, pomalidomide, and dexamethasone, and daratumumab, carfilzomib, and dexamethasone. Dr. Goldsmith acknowledges the limitations of cross-trial comparisons and the absence of prospective head-to-head trials conclusively establishing the superiority of one regimen over another. However, he emphasizes that the depth of response, MRD negativity rates, and their association with PFS provide useful evidence for treatment selection. He explains that outcomes from earlier trials can serve as benchmarks when evaluating newer options. The discussion considers the potential role of daratumumab, iberdomide, and dexamethasone compared with older triplets in appropriate patients, while underscoring the importance of evaluating available evidence and offering patients treatment options associated with favorable outcomes.