Eliminating Necessity for Sequential Assessment for Progressive Disease Among Patients With Relapsed Multiple Myeloma
According to results from a retrospective study, additional confirmatory tests are not needed to determine disease progression among patients multiple myeloma (MM) after 2 biomarkers have indicated progressive disease (PD) at the same time.
These results were presented by Jean-Sébastien Claveau, MD, Mayo Clinic, Rochester, Minnesota, at the 66th ASH Annual Meeting in San Diego, California.
Patients with multiple myeloma (MM) may have their line of treatment altered after initial progressive disease (PD) assessment, resulting in inaccuracies in testing and underestimation of progression rate. Researchers sought to assess the need for repeated testing following 2 biomarkers previously matching criteria of progression to confirm PD.
“We showed that the simultaneous criteria allow to identify patients with true progressive disease without overestimating the progression rate of myeloma,” Claveau and colleagues concluded, “therefore, confirmatory results of progression for relapsed MM patients having 2 biomarkers meeting criteria of progression at the same time is useless for determining disease progression.”
Transcript:
My name is Jean-Sébastien Claveau. I'm hematologist at Hospital Meison of Rosemore in Montreal, Canada. I did my fellowship at Mayo Clinic Rochester. At the ASH 2024 meeting, I presented about eliminating the need of sequential assessment for progressive disease in patients with multiple myeloma.
Currently, according to the International Working Myeloma Group, also called the IMWG, we need to do 2 assessments to confirm that a patient is relapsing, that they have a progressive disease. The tests more frequently used are the serum electrophoresis, the serum free light chain, the urinary electrophoresis, and also the bone marrow examination. All these 4 tests are used to confirm the response of the treatment. They are based on blood tests, urinary tests, or bone marrow samples.
The biggest issue currently is that you need to do 2 tests at 2 different times to confirm that the patient is really progressing, but sometimes, some patients are not able to do the second test. For example, if a patient is rapidly progressing, sometimes you need to change treatment and you are not able to do the second test. In other situations, we also have patients that are leaving some clinical trial, some research protocol, just after doing 1 test and without having any confirmations of the progressing disease. And that can cause some issues with the design of the test.
What we show is that if we use or if a patient is meeting the criteria of progressions, with 2 of the 4 tests that I said earlier, we can show that the patient is relapsing, avoiding to [have to] do a second assessment so the patients don't need to come a second time at the hospital to do some blood tests or some urinary tests to confirm that is having a progressive disease. That's pretty relevant, especially that we will change the criteria of progressions, the criteria of assessment of respond soon in the next few months or the next few years.
We think that it's really relevant because if we just need to do 1 test instead of doing 2 tests at 2 different moments, the patients will not need to come to the hospital 2 times. We can also change the treatment faster and we can at that time prevent complications from myeloma such as bone lesions or bone fracture. It can be really useful to increase the quality of life of patients living with multiple myeloma.
Source:
Claveau JS, Dispenzieri A, Kapoor P, et al. Eliminating the need for sequential confirmation of response in multiple myeloma. Dec 7-10, 2024; San Diego, CA. Abstract: 83