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News
The NCCN has released Version 1.2027 of its Multiple Myeloma Guidelines, significantly expanding minimal residual disease (MRD) testing recommendations and adding new treatment regimens. MRD testing is now preferred at a sensitivity of 10⁻⁶ and should be tracked at multiple points throughout treatment—including annually during maintenance and after CAR T-cell therapy. New frontline and relapsed/refractory regimens, including isatuximab-based and T-cell–redirecting combinations, were also added.
The National Comprehensive Cancer Network (NCCN) has released Version 1.2027 of its Multiple Myeloma Clinical Practice Guidelines, introducing a dedicated section on minimal residual disease (MRD) testing and expanding the recommended time points for assessment. MRD testing via next-generation sequencing (NGS) or multicolor flow cytometry is now preferred at a sensitivity of 10⁻⁶—a threshold tied to better prognostic discrimination—with 10⁻⁵ as the minimum acceptable level.
The updated guidelines emphasize that MRD should be monitored longitudinally, not just at a single point. Sustained MRD negativity is now recognized as more clinically meaningful than a one-time negative result, and the guidelines open the door to treatment discontinuation in select patients who maintain MRD negativity over time. On the treatment front, isatuximab plus carfilzomib, lenalidomide, and dexamethasone (KRd) earned a category 1 frontline recommendation, while the relapsed/refractory section was reorganized by prior lines of therapy and expanded with belantamab mafodotin and multiple talquetamab-based combinations.
Key Takeaways:
Why it matters: These updates move multiple myeloma management toward a more personalized, response-guided approach—where MRD data can inform not just treatment intensity, but also when it may be safe to stop therapy altogether.
