Dana-Farber Cancer Institute investigators presented encouraging results from three studies focused on early detection and interception of multiple myeloma at the 66th American Society of Hematology (ASH) Annual Meeting & Exposition. These studies offer new tools and insights for predicting and detecting multiple myeloma at its earliest stages, potentially leading to earlier interventions and improved patient outcomes.
MM-like Score for Early Intervention
Researchers developed a "Multiple Myeloma-like" (MM-like) score using genomic markers to predict the risk of progression to multiple myeloma in patients with precursor conditions like monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). The MM-like score incorporates whole-genome sequencing data from over 1000 patients, identifying key genomic alterations enriched in MGUS or multiple myeloma. According to Dr. Irene Ghobrial, senior author of the study, this tool adds to the prognostication toolbox by taking a broader view of genomics than previous models, potentially enabling clinicians to identify patients who would benefit from early intervention to prevent or delay disease progression.
Unveiling Earliest Stages of Multiple Myeloma
A study revealed that abnormal proteins called M-proteins, or monoclonal gammopathies, can be detected in the blood up to 22 years before a diagnosis of MGUS or multiple myeloma. Using mass spectrometry, investigators tracked specific B cell clones and found that in 77% of cases, one dominant B cell clone persisted until disease progression, while in the remaining 23%, different clones dominated at various times. This finding, presented by Dr. Sabine Allam, highlights the potential for early detection and interception strategies by identifying the earliest monoclonal gammopathies. "These findings reveal multiple myeloma’s earliest stages of disease development, enabling investigators to develop novel strategies for prevention, early detection, and interception of multiple myeloma," said Dr. Ghobrial.
PANGEA 2.0 Improves Risk Stratification in SMM
Investigators developed PANGEA 2.0, a tool designed to improve risk stratification for patients with smoldering multiple myeloma. The model was created and validated using clinical data from 1,431 participants across four international sites. PANGEA 2.0 was compared to the current gold standard, 20/2/20, and demonstrated improved risk predictions, particularly for patients with evolving biomarker values. Dr. Floris Chabrun, presenting author, advocated for the incorporation of PANGEA 2.0 trajectories into collaborative international studies to further refine risk assessment and treatment strategies for SMM patients.
