The BOTTOM LINE: While these are early findings being presented at the 63rd ASH meeting, the iStopMM study will be revealing new and important observations for years to come.
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This week’s “Ask Dr. Durie” came from a patient who had just noticed that at the upcoming ASH meeting, there are four abstracts scheduled for presentation that are oral presentations and they come from the same Iceland research project called iStopMM, Iceland Screens, Treats, or Prevents Multiple Myeloma, which is an IMF-funded project.
Four oral presentations from a single project, I have to say, are pretty amazing. This patient wants to know that if that’s the case, this must be important. So, in what way are these data important?
And so, good question. This screening project in Iceland involves the screening of individuals over the age of 40 and over 80,000 individuals agreed to participate in this randomized trial. This is the largest randomized trial that’s ever been conducted in any type of cancer research.
Because the patients are agreeing, they sign through the IRB (institutional review board) to potentially have extra bone marrows done, to get extra scanning tests and blood work done. So, it is amazing that the Icelandic people have been so committed to this research project.
And so, the initial results beyond just documenting the success of the screening project led by Dr. Sigurdur Kristinsson at the University of Iceland, I should say my congratulations certainly go to Sigurdur and his team who have shown that they can do this, that they have important findings, for example, in the MGUS patients, over three-thousand picked up so far, they’ve found out that the outcomes with COVID infection were not more than the general population, an important finding.
They also noted that in the screening they picked up a lot more patients with smoldering myeloma than they expected. And this is important because it gives the opportunity to intervene early and give the chance for possible curative therapy, part of the Black Swan project where we’re offering intensive treatment early to achieve the best response.
They have also noted that in patients who have kidney problems where the kidney function is reduced that one can use a special system of tracking so that the levels of the free light chains can be adjusted related to the level of the kidney function. And so, you could more accurately diagnose the occurrence of MGUS or low-level disease even despite the kidney function which raises the level of the light chains because of the impact of kidney function.
So, the BOTTOM LINE is that these are just the early findings from the very, very large study, and ongoing there will be very many new observations. One is instead of using serum protein electrophoresis (SPEP), we’re using mass spectrometry to measure the myeloma protein left. And this will lead to a lot of new findings.
In addition, for all of the individuals in Iceland who have MGUS or don’t have MGUS, we have full DNA genetic sequencing information available. And so, we will be able to determine what are the genetic features that predispose to the onset of MGUS and then to the progression into multiple myeloma. And so, the presentations at ASH are very important but are just setting the stage for what will be many important observations in the months and years to come.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF and a member of the IMF Board of Directors.
