How does mass spectrometry compare to traditional myeloma-protein testing methods?

In this week’s video, Dr. Durie discusses the new myeloma protein level test called mass spectrometry, and how this test compares to currently used testing methods. 

Mass spectrometry is a new highly sensitive test that measures the mass of a myeloma protein cell. It has the potential to detect MRD-negativity. The cost of the test is anticipated to be less than $200 per test.

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This week’s “Ask Dr. Durie” comes from a lady who has heard about a new testing method called mass spectrometry. This is something that I have talked about before, but she’s asking if I can perhaps explain more fully, I am certainly glad to do this. 
And so, the key thing is that we have several methods available to evaluate myeloma proteins. The traditional approach that we use right now is to use serum protein electrophoresis and immunofixation. With those two tests, we can determine the amount and the type of a myeloma protein. And so, this is the standard method.  
The new mass spectrometry method is a new technique which focuses on the exact mass or weight of the myeloma protein, which is very very precise. And, this allows, with this technology, to monitor the exact level of this weight of protein in the serum. So, using a simple serum test, you can measure the amount of this protein. And, the technique allows you to characterize the type of the protein. So, it could be for example, IgG Kappa. And so, this is information which is similar to SPEP plus immunofixation, but actually better, more sensitive, and more precise. 
And so, what is the expectation for mass spectrometry moving forward? Well, it is very sensitive for day-to-day monitoring. And, what is even more interesting is that with some extra technical enhancement, it’s actually possible to improve the methodology so that sensitivity can be down to the range of ten to the minus six, which can pick up at a level of myeloma cells, which is zero out of a million, which is what we use for typical minimal residual disease testing using NGF or NGS. And so, it could be quite amazing is a simple serum test using mass spectrometry could be used both for initial diagnosis and for monitoring day-to-day, even down to the level of MRD-negativity.  
And so, there is a lot of excitement about the availability of this test. At the present time, samples can be sent to the Mayo Clinic in Rochester, Minnesota, where testing is possible using a routine lab request. 

In the latter part of this year, and into next year, testing will be available at a variety of other centers across the country. And, there is a high level of expectation that the FDA will actually go ahead and approve this technology relatively soon. 

And so, the BOTTOM LINE is that this is an exciting new sensitive test for the evaluation of myeloma which could really transform the way that we assess the disease. A very quantitative way, a very sensitive way, and in a very simple way with a blood serum test. which, fortunately, turns out to be quite inexpensive. It looks like the cost of this test will be less than two-hundred dollars per test. And so, very very important to be aware of the upcoming availability of this new testing methodology. 

Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.


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