Non-invasive, inexpensive analytical tool predicts survival in multiple myeloma
Post-induction of a mass spectrometry tool called Mass-Fix predicted survival outcomes among patients with multiple myeloma participating on the STAMINA trial.
Mass-Fix, mass spectrometry of blood by MALDI, is an inexpensive, sensitive and specific means of non-invasively uncovering monoclonal immunoglobulins, according to the abstract presented at the virtual ASCO Annual Meeting.
“There are many advantages,” Angela Dispenzieri, MD, from the division of hematology at Mayo Clinic, said in her presentation. “It's more sensitive than immunofixation. It can differentiate M-proteins from therapeutic monoclonal antibodies. It's good for complete response. Part of this project is we think it's good for MRD measurement. It certainly can be used for serial measurements.”
In this prospective clinical trial, researchers assessed whether Mass-Fix was superior to existing methodologies to predict survival outcomes using samples from the STAMINA trial, which compared three transplant approaches among patients who have already received induction.
The investigators tested samples from enrollment post-induction (post-I) and 1-year post enrollment from 575 patients with multiple myeloma. They examined four response parameters: Mass-Fix, serum immunofixation electrophoresis (SIFE), complete response and minimal residual disease (MRD) by next generation flow cytometry, and they examined mass spectrometry spectra in a blinded fashion. To evaluate the independent effect of the different response parameters on PFS and OS as well as interactions with other risk factors, they created multivariate Cox proportional hazard models using stepwise regression.
At multiple testing points on multivariate analyses, only MRD and Mass-Fix predicted for PFS and OS of the four response parameters. The results showed that although only MRD predicted for PFS post-induction, Mass-Fix was the only post-induction measurement to predict for OS. In addition, 1-year post-enrollment Mass-Fix and MRD predicted for inferior PFS and OS.
In her presentation, Dispenziera said that post-induction Mass-Fix is the only response measure to be prognostic for OS and that it predicted for PFS and OS independently of MRD status by high-resolution after 1 year.
“Mass-Fix provides a convenient and non-invasive means of predicting outcomes for myeloma patients,” Dispenzieri said. “Future directions will include comparison of Mass-Fix by next gen sequencing to determine whether Mass-Fix can detect early relapse.”
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Dispenzieri A, et al. Abstract 8009. Presented at: ASCO Annual Meeting; June 4-8, 2021 (virtual meeting).
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