Understanding Blood-Based Testing in Multiple Myeloma with Ola Landgren, MD, PhD
May 31, 2023
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Dr. Ola Landgren discusses the rise of blood-based tests for myeloma care, highlighting the benefits of less invasive testing methods such as mass spectrometry, MRD testing, and circulating tumor cell testing. These tests offer a more comfortable and informative experience for patients and doctors, potentially replacing bone marrow biopsies. The podcast delves into the different types of blood-based tests, their functions, and how they could enhance myeloma practice in the future.
Blood-based tests offer less invasive multiple myeloma tracking with potential for regular monitoring.
Mass spectrometry, MRD assays, cell sequencing, and flow cytometry are emerging technologies for myeloma testing.
Collaboration between researchers and clinicians is crucial for optimizing blood-based tests in myeloma patient care.
Deep dives
Blood-Based Tests for Multiple Myeloma
Blood-based tests are being developed to track multiple myeloma, offering a more convenient alternative to bone marrow biopsies. New technologies like mass spec tests and MRD-based assays, such as Binding Site Test, are emerging. These tests utilize serum samples to analyze abnormal proteins, offering faster and more sensitive detection compared to traditional methods like immunofixation tests.
Sebia Test and MRD Tracking
The Sebia test, also a mass spec test, focuses on analyzing peptides, offering precise tracking of disease using patient-specific sequences. This technology is more sensitive than standard tests and holds potential for detecting minimal residual disease and disease recurrences. However, the challenge lies in accurately determining the peptide baseline and ensuring reproducibility across different lab settings.
Adaptive Clono-Seq Test and Sequencing
The Adaptive Clono-Seq test utilizes individual cell sequencing to identify unique immune cell signatures associated with multiple myeloma. By tracking these signatures post-treatment, it provides a reliable method for detecting residual disease. While the technology shows promise in precision and sensitivity, further research is essential to establish its broader clinical utility.
Flow-Based MOD Testing
Flow-based MOD testing, like EuroFlow, employs flow cytometry to analyze cell surface markers, offering a standardized and rapid assessment of disease. While less sensitive than sequencing methods, flow cytometry serves as a widely available tool for efficient disease monitoring and assessment. Challenges include ensuring proper marker selection and sample volume for accurate results.
Circulating Tumor Cells and Liquid Biopsies
Circulating tumor cell tests explore whole cell sequencing in blood samples to detect disease characteristics. While providing comprehensive molecular insights, these tests face limitations in capturing less disease content compared to bone marrow biopsies. Ongoing research aims to enhance the sensitivity and clinical applicability of these liquid biopsies.
Future Perspectives on Test Implementation
Dr. Landgren emphasizes the ongoing implementation of diverse testing methods in multiple myeloma patient care and research. While advancements in blood-based tests show promise for disease tracking and management, further research is warranted to optimize their clinical utility and establish their role in routine diagnostics. Collaboration between researchers and clinicians is vital for comprehensive data interpretation and enhancing patient outcomes.
A wave of blood-based tests are being researched for myeloma care, and for good reason. Patients love the idea of replacing the painful bone marrow biopsy with a blood-based test, especially if it is equally effective. In addition to being less time consuming and painful, blood-based testing could be performed more regularly to provide more information to patients and their doctors.
The types of test vary. They include mass spectometry testing, blood-based MRD testing and circulating tumor cell testing. Many of these tools are still only used in research, but they are getting closer to being used in the myeloma clinic. Each of the tests have unique ways of providing a less invasive way of testing for myeloma at diagnosis and after treatment.
Ola Landgren, MD, PhD of the University of Miami Sylvester Cancer Center joins HealthTree Podcast for Multiple Myeloma to review the different types of tests, how they function, what they measure, pros and cons of each and how they are and could be used in regular myeloma practice.
As we continue to see these tests advance, it's a great idea to start becoming more familiar with the test types, test names and reasons for their use.
Thanks to our episode sponsor, GSK
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