Attitudes and perspectives of oncologists about measurable residual disease testing in multiple myeloma: initiative for standardizing guidelines.

Abstract

Measurable residual disease (MRD) testing is emerging as a crucial prognostic and treatment-guiding tool in multiple myeloma (MM). Despite its potential, routine clinical adoption remains inconsistent. This study aimed to explore oncologists' perspectives on MRD testing and identify barriers and facilitators to its clinical integration. A cross-sectional, modified Delphi survey was conducted among hematologists and oncologists globally, and 115 responses were received. Our findings reveal significant variability in MRD testing, influenced primarily by specialty rather than geographic location, years of experience, or practice setting (academic vs community settings). Plasma cell-focused physicians were more likely to conduct routine MRD testing. Flow cytometry was the preferred testing methodology globally, with significant variations in acceptable negativity thresholds. The primary purpose of MRD testing was to guide treatment decisions; however, U.S. physicians employed it primarily to discuss results with patients. Key barriers to assessment included testing unavailability, lack of standardized guidelines, and, in non-U.S. settings, financial constraints. These findings highlight the need for consensus-driven guidelines to standardize MRD implementation, improve accessibility, and educate clinicians on its clinical utility. Addressing these gaps will be essential to leveraging MRD as a routine decision-making tool, ultimately optimizing patient outcomes in MM.