Single-point and kinetics of peripheral residual disease by mass spectrometry to predict outcome inpatients with high-risk smoldering multiple myeloma included in the GEM-CESAR trial
Por:
Puig, N, Agullo, C, Contreras, T, Perez, JJ, Aires, I, Calasanz, MJ, Garcia-Sanz, R, Castro, S, Martinez-Lopez, J, Rodriguez-Otero, P, Gonzalez-Calle, V, Gonzalez, MS, Oriol, A, Gutierrez, NC, Rios-Tamayo, R, Rosinol, L, Alvarez, MA, Bargay, J, Gonzalez-Rodriguez, AP, Alegre, A, Escalante, F, Inigo, MB, de la Rubia, J, Teruel, AI, de Arriba, F, Palomera, L, Hernandez, MT, Lopez-Jimenez, J, Reinoso, M, Garcia-Mateo, A, Ocio, EM, Blade, J, Lahuerta, JJ, Cedena, MT, Paiva, B, Miguel, JFS and Mateos, MV
Publicada:
1 dic 2024
Ahead of Print:
1 dic 2024
Resumen:
The value of quantitative immunoprecipitation mass spectrometry (QIP-MS) to identify the M-protein is being investigated in patients with monoclonal gammopathies but no data are yet available in high-risk smoldering myeloma (HRsMM). We have, therefore, investigated QIP-MS to monitor peripheral residual disease (PRD) in 62 HRsMM patients enrolled in the GEM-CESAR trial. After 24 cycles of maintenance, detecting the M-protein by MS or clonal plasma cells by next-generation flow cytometry (NGF) identified cases with a significantly shorter median progression-free survival (mPFS) (MS: not reached vs. 1.4 years, P =0.001; NGF: not reached vs. 2 years, P =0.0002) but reaching complete response (CR) + stringent CR (sCR) did not discriminate between patients with different outcome. With NGF as a reference, the combined results of NGF and MS showed a high negative predictive value (NPV) of MS: 81% overall and 73% at treatment completion. When sequential results were considered, sustained negativity by MS or NGF was associated with a very favorable outcome with an mPFS not yet reached versus 1.66 years and 2.18 years in cases never attaining PRD or minimal residual disease (MRD) negativity, respectively. We can, thus, conclude that: 1) the standard response categories of the International Myeloma Working Group do not seem to be useful for monitoring treatment in HRsMM patients; 2) MS could be used as a valuable, non-invasive, clinical tool with the capacity of guiding timely bone marrow evaluations (based on its high NPV with NGF as a reference); and 3) similarly to NGF, sequential results of MS are able to identify a subgroup of HRsMM patients with long-term disease control. This study was registered at www.clinicaltrials.gov ( clinicaltrials.gov identifier: 02415413).
Filiaciones:
Puig, N:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Agullo, C:
Univ Hosp Salamanca, Dept Biochem, Salamanca, Spain
Contreras, T:
Univ Hosp Salamanca, Dept Biochem, Salamanca, Spain
Perez, JJ:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Aires, I:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Calasanz, MJ:
Univ Navarra, Ctr Invest Med Aplicada CIMA, IDISNA, IDISNA,CIBERONC,Canc Ctr Clin, CIBER ONC CB16-12-00369 & CB16-12-00489, Pamplona, Spain
Garcia-Sanz, R:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Castro, S:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Martinez-Lopez, J:
Complutense Univ i 12, I 12 Res Inst, Spanish Natl Canc Res Ctr CNIO, Hematol Dept,Med Sch, Madrid, Spain
Rodriguez-Otero, P:
Univ Navarra, Ctr Invest Med Aplicada CIMA, IDISNA, IDISNA,CIBERONC,Canc Ctr Clin, CIBER ONC CB16-12-00369 & CB16-12-00489, Pamplona, Spain
Gonzalez-Calle, V:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
Gonzalez, MS:
Hosp Clin Univ Santiago Compostela, Dept Hematol, Santiago De Compostela, Spain
:
Hosp Germans Trias I Pujol, Inst Catala Oncol, Clin Hematol, Badalona, Spain
Hosp Germans Trias I Pujol, Josep Carreras Res Inst, Badalona, Spain
Gutierrez, NC:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
Rios-Tamayo, R:
Hosp Univ Puerta Hierro Majadahonda, Unidad Gammapatias Monoclonales, Majadahonda, Spain
Rosinol, L:
Hosp Clin Barcelona, ICMHO, Hematol Dept, Barcelona, Spain
Alvarez, MA:
Hosp Univ Reina Sofia, Cordoba, Argentina
Bargay, J:
Hosp Univ Son Llatzer, Inst Invest Sanitaria Illes Balears IdiSBA, Serv Endocrinol & Nutr, Palma De Mallorca, Spain
Gonzalez-Rodriguez, AP:
Hosp Univ Cent Asturias, Hematol Dept, Oviedo, Spain
Alegre, A:
La Princesa Univ Hosp, Madrid, Spain
Univ Autonoma Madrid, Univ Hosp QuironSalud, Madrid, Spain
Escalante, F:
Complejo Asistencial Univ Leon, Serv Hematol, Unidad i i, Leon, Spain
Inigo, MB:
Hosp Clin San Carlos, Dept Hematol, Madrid, Spain
de la Rubia, J:
Hosp Univ Politecn Fe, Univ Catolica Valencia, Valencia, Spain
Teruel, AI:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
de Arriba, F:
Dept Hematol Hosp Univ Morales Meseguer, Hosp Univ Morales Meseguer, Ctr Reg Hemodonac, Murcia, Spain
Palomera, L:
Hosp Clin Univ Lozano Blesa, Hematol Dept, Inst Invest Sanitaria Aragon, Zaragoza, Spain
Hernandez, MT:
Hosp Univ Canarias, Immunol Dept, Santa Cruz De Tenerife, Spain
Lopez-Jimenez, J:
Hosp Ramon & Cajal, Hematol Dept, Madrid, Spain
Reinoso, M:
Univ Seville, Hosp Univ Virgen Rocio, Dept Hematol, Inst Biomed Sevilla IBIS,CSIC, Seville 41013, Spain
Garcia-Mateo, A:
Complejo Asistencial Segovia, Hematol Dept, Segovia, Spain
Ocio, EM:
Univ Cantabria, Hosp Univ Marques Valdecilla IDIVAL, IDIVAL, Santander, Spain
Blade, J:
Hosp Clin Barcelona, ICMHO, Hematol Dept, Barcelona, Spain
Lahuerta, JJ:
Hosp Univ 12 Octubre, Inst Invest, Madrid, Spain
Cedena, MT:
Hosp Univ 12 Octubre, Hematol Dept, Inst Invest i, Madrid, Spain
Paiva, B:
Univ Navarra, Ctr Invest Med Aplicada CIMA, IDISNA, IDISNA,CIBERONC,Canc Ctr Clin, CIBER ONC CB16-12-00369 & CB16-12-00489, Pamplona, Spain
Miguel, JFS:
Univ Navarra, Ctr Invest Med Aplicada CIMA, IDISNA, IDISNA,CIBERONC,Canc Ctr Clin, CIBER ONC CB16-12-00369 & CB16-12-00489, Pamplona, Spain
Mateos, MV:
Hosp Univ Salamanca, IBSAL, Ctr Invest Canc IBMCC USAL CSIC, Salamanca, Spain
CSIC, Ctr Invest Canc, IBMCC, USAL, Salamanca, Spain
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