What Are Some Of the Breakthroughs in Myeloma Research Made By the BSRI? 

This week's "Ask Dr. Durie" comes from a patient who wants to know what is the Black Swan Research Initiative? This is a very good question, and there have been a number of patients and caregivers who have been asking about this recently because of results presented at different research meetings. The Black Swan Research Initiative was developed back in 2012 following a brainstorming meeting which occurred at the time of the European Hematology Association meeting in Amsterdam. 

And, coming out of this meeting there were some strong directives, that indicated that if we wanted to cure myeloma, the first thing was that we needed to have accurate testing to evaluate deep response, which was using a test called minimal residual disease (MRD) testing to look for small amounts of myeloma remaining in the bone marrow after decisive therapy. 

The next thing that we needed was to come up with an optimal treatment protocol to treat patients such that they might be achieving very low levels of disease. And the MRD test could in fact be negative. And so, coming out of this meeting in 2012, the Spanish team was really the first to jump in and say, yes, they were keen to be part of the Black Swan Research Initiative and Dr. Alberto Orfao set up a project which the IMF supported and funded to develop a next-generation flow (NGF) method to detect myeloma in the bone marrow at very, very low levels—an MRD test using flow cytometry in the bone marrow. It took Alberto over two years to develop this test. And here now in 2023, this method is headed for commercialization.  

In the meantime, one of his colleagues, Dr. Maria V. Mateos, said, Well, yes, she was keen to be involved and established a cure trial where she identified patients early in the disease with high-risk smoldering myeloma and offered a treatment using the combination of Kyprolis, REVLIMID and dex plus autologous stem cell transplant (ASCT) as treatment for high-risk smoldering myeloma and monitoring, using the new MRD test to see if cure could be achieved. 

And so here we are, ten years later, that trial has been completed. And with follow up following treatment out in the 6-to-7 year range. And basically at this point, it seems that about half of the patients will have sustained MRD negative at that time range and beyond. And over 90% of the patients are still alive and without need for further therapy. 

And so, the bottom line is that the Black Swan Research Initiative is really a key initiative involved in the search for finding a cure for myeloma. And these first projects illustrate the achievements that stemmed right from the first brainstorming meeting. 

The BOTTOM LINE is that this is just one illustration of the accomplishments. And so, in some follow-up videos, I'll go forward and explain some of the many other projects that stemmed out of the original brainstorming meeting and many of the other accomplishments from BSRI, the Black Swan Research Initiative. And so, a very, very good question. And identifying a project that is making a very, very important series of observations in the field of myeloma.