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We used a modified Delphi approach to establish areas of consensus and nonconsensus regarding the utility of determining measurable residual disease (MRD) to assess multiple myeloma (MM) treatment response, which may inform disease management and design of future clinical trials. This modified Delphi study incorporated 2 iterative rounds of surveys to evaluate the opinions of an expert panel of 61 practicing hematological oncologists from across 14 countries in Europe concerning the use of MRD testing in MM management. Survey 1 assessed experts' opinions on MRD testing in different clinical situations and associated challenges. Survey 2 focused on the lack of consensus areas identified in survey 1. Consensus to an individual question was defined a priori as 75% agreement or disagreement by the panel. From the 2 rounds of surveys, the experts reached consensus agreement that MRD testing should be performed in newly diagnosed or relapsed patients who achieved complete response (CR) or better after transplantation. In transplant-ineligible patients, experts recommended MRD testing in those who are ≤70 years old and in CR. If a patient was previously positive on positron-emission tomography and computed tomography (PET/CT), both MRD and PET/CT should be assessed at CR. MRD testing should be performed ≤6 months after transplantation and every 6-12 months in continuously treated patients in CR. There was no consensus on making treatment decisions based on MRD status. MRD testing is an important component of clinical management in MM. Additional data will further clarify the role of MRD in guiding treatment decisions., Competing Interests: KR: Has served as an advisor for and received honoraria from Janssen, Adaptive Biotechnologies, Amgen, Takeda, Abbvie, Oncopeptides, Celgene – Bristol Myers Squibb, Pfizer, and GSK. Has received grant funding from Janssen, Amgen, Takeda, GSK and Celgene – Bristol Myers Squibb. HA-L: Has served as an advisor for and received honoraria from Amgen, Bristol Myers Squibb, Celgene, Janssen, Sanofi, GSK, Takeda, and Adaptive Biotechnologies. CHB: Has served as an advisor for and received honoraria from Amgen, Bristol Myers Squibb, Takeda, Sanofi, GSK, and Adaptive Biotechnologies. MD: Has served as an advisor for and received honoraria from Amgen, Celgene – Bristol Myers Squibb, GSK, Janssen, Sanofi, and Takeda. FG: Has served as an advisor for Janssen, Amgen, Celgene – Bristol Myers Squibb, Adaptive Biotechnologies, Roche, Abbvie, GSK, Takeda, Bluebird Bio, Oncopeptides, Pfizer, and Sanofi. Has received honoraria from Janssen, Amgen, Celgene – Bristol Myers Squibb, GSK, Takeda, and Sanofi. SM: Has served as an advisor for Abbvie, Adaptive Biotechnologies, Amgen, Celgene – Bristol Myers Squibb, GSK, Janssen, Oncopeptides, Pfizer, Regeneron, Roche, Sanofi, and Takeda. JM-L: Has served as an advisor for and received honoraria from Amgen, Bristol Myers Squibb, Celgene, Janssen, Sanofi, GSK, Incyte, Roche, Pfizer, Novartis and Adaptive Biotechnologies. MVM: Has served as an advisor for and received honoraria from Janssen, Celgene – Bristol Myers Squibb, Takeda, Amgen, Adaptive Biotechnologies, Oncopeptides, Sanofi, Roche, Regeneron, and Pfizer. MM: Has received honoraria from Amgen, Astellas, Bristol Myers Squibb, Celgene, Gilead, Janssen, Jazz, Takeda, Novartis, Pfizer, Sanofi, and Adaptive Biotechnologies. Has received research funding from Celgene, Janssen, Jazz, and Sanofi. NWCJvdD: Has served as an advisor for Janssen Pharmaceuticals, Amgen, Adaptive Biotechnologies, Celgene, Bristol Myers Squibb, Novartis, Roche, Takeda, Bayer, and Servier. Has received grant funding from Janssen Pharmaceuticals, Amgen, Celgene, Cellectis, and Bristol Myers Squibb. KW: Has served as an advisor for Amgen, Adaptive Biotechnologies, Bristol Myers Squibb, Celgene, GSK, Janssen, Karyopharm, Oncopeptides, Sanofi, and Takeda. Has received honoraria from Amgen, Adaptive Biotechnologies, Bristol Myers Squibb, Celgene, GSK, Janssen, Karyopharm, Oncopeptides, Sanofi, Takeda, and Roche. Has received grant funding from Amgen, Janssen, Celgene, and Sanofi (to the institution)., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)

Competing Interests: MAD reported consultancy and honoraria from Janssen, Celgene, Takeda, Amgen and Bristol Myers Squibb. PM reported honoraria from Celgene, Janssen, Takeda, Amgen and Abbvie. ET reported honoraria from Bristol Myers Squibb, Janssen, Celgene, Takeda, Genesis Pharma, Amgen, Sanofi and Novartis and research funding from Janssen, Amgen, Takeda, Sanofi and Genesis Pharma. MVM reported honoraria from lectures and boards from Janssen, Celgene, Amgen, Takeda, Abbvie, GlaxoSmithKline, Adaptive, Roche and Seattle Genetics. SZ reported participation in advisory boards for Takeda, Celgene, Janssen, Sanofi and Oncopeptides and research funding from Celgene, Janssen and Takeda. GC reported being a member of speaker bureau for Takeda, Bristol Myers Squibb, Celgene, Amgen, Sanofi and Janssen and has received research grants from Bristol Myers Squibb, Celgene and Takeda. MD reported honoraria from Abbvie, Adaptive Biotechnologies, Amgen, Bristol Myers Squibb, Celgene, Janssen, Karyopharm, Sanofi and Takeda and has received research funding from Bristol Myers Squibb, Celgene, Janssen and Takeda. RH reported consultant or advisory roles for Janssen, Amgen, Celgene, AbbVie, Bristol Myers Squibb, Novartis, PharmaMar and Takeda; honoraria from Janssen, Amgen, Celgene, Bristol Myers Squibb, PharmaMar and Takeda and has received research grants from Janssen, Amgen, Celgene, Bristol Myers Squibb, Novartis and Takeda. FS reported honoraria from Amgen, Celgene, Bristol Myers Squibb, Takeda, Abbvie, Janssen, Novartis, SkyliteDX, Oncopeptides, Sanofi, GlaxoSmithKline, Adaptive and Merck Sharp & Dohme. MC reported honoraria from Janssen, Celgene, Amgen, Bristol Myers Squibb, Takeda, AbbVie, Sanofi and Adaptive Biotechnologies and speaker’s bureau membership for Janssen and Celgene. HG reported grants from Amgen, Bristol Myers Squibb, Celgene, Chugai, Dietmar-Hopp-Foundation, Janssen, John Hopkins University and Sanofi; research support from Amgen, Bristol Myers Squibb, Celgene, Chugai, Janssen, Incyte, Molecular Partners, Merck Sharp & Dohme, Sanofi, Mundipharma, Takeda and Novartis; participation in advisory boards for Adaptive Biotechnology, Amgen, Bristol Myers Squibb, Celgene, Janssen, Sanofi, Takeda; honoraria from Academy2 GmbH & Co. KG, Amgen, ArtTempi, Bristol Myers Squibb, Celgene, Chop GmbH, Chugai, FomF GmbH, GlaxoSmithKline, GWT Forschung und Innovation Dresden, InVo Institut für Versorgungsforschung in der Onkologie GbR, Janssen, Kompetenznetz Maligne Lymphome (KML), MedConcept GmbH, Medical Communication GmbH, New Concept Oncology, Novartis, Omnia Med Deutschland, Sanofi. TF reported speaker and advisory roles for Janssen, Bristol Myers Squibb, Takeda, advisory role for Roche, Sanofi, Karyopharm and Oncopeptides and Speaker for Amgen. HE reported consulting and advisory roles for Bristol Myers Squibb, Celgene, Janssen, Amgen, Takeda, Sanofi and GlaxoSmithKline; research funding from Bristol Myers Squibb, Celgene, Janssen, Amgen, GlaxoSmithKline and Sanofi; honoraria from Bristol Myers Squibb, Celgene, Amgen, Takeda, Sanofi and GlaxoSmithKline. MB has received honoraria from Sanofi, Celgene, Amgen, Janssen, Novartis, Bristol Myers Squibb and AbbVie; has served on the advisory boards for Janssen and GlaxoSmithKline; has received research funding from Sanofi, Celgene, Amgen, Janssen, Novartis, Bristol Myers Squibb and Mundipharma. JS-M reported consultancy for Amgen, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, GlaxoSmithKline, Takeda, Sanofi and Roche. PS reported honoraria and advisory roles for Celgene, Janssen, Amgen, Takeda, Bristol Myers Squibb and Skyline and research funding from Celgene, Amgen, Janssen and Takeda. UM reported honoraria from Celgene, Janssen, Amgen, Takeda, AbbVie, Bristol Myers Squibb and Sanofi.

The introduction of new agents and management strategies over the past decade has resulted in a major step change in treatment outcomes with deepening responses and increased survival for patients with multiple myeloma. In daily clinical practice, healthcare professionals are now faced with challenges including, optimal treatment sequencing and changing treatment goals. In light of this, a group of experts met to discuss diagnostic and treatment guidelines, examine current clinical practice, and consider how new clinical trial data may be integrated into the management of multiple myeloma in the future., Competing Interests: K Jamroziak declares no conflicts of interest. M. Leiba declares no conflicts of interest. K. Yong declares no conflicts of interest. Funding from UCL/UCLH Biomedical Research Centre., (Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association.)