Dr Ely talks to ecancertv at the 14th International Myleoma Workshop (IMW 2013), Kyoto, Japan, 3-7th April 2013.
There are now several treatment options for myeloma but little data to help decide which drugs to use.
A proliferation assay devised in the 1980s showed proof of principle, that assessment of proliferation is an accurate predictor of clinical behavior.
Since then, for technical reasons, clinical implementation of a proliferation assay has not been successful. The researchers invented an immunohistochemical platform (U.S. patents applied) to assess myeloma proliferation. Unlike prior methods, it is performed at the single-cell level, on routinely-preserved marrow, using standard laboratory equipment.
The test can be read manually or via image analysis, using the software (U.S. copyright applied) which runs on any PC or Mac. The prospective analysis of patients followed 14 years after an IRB-approved BMT trial showed an inverse correlation between survival and myeloma cell proliferation (P = 0.006). Also, the retrospective cohort study showed that each 1% increase in proliferation was associated with a 3% increase in risk of progression (P = 0.02). PFS was 232 weeks vs. 110 weeks for <10% vs. >10%, respectively (P = 0.03).
The new assay provides reliable prognostic information that can be used to approach care on a patient-specific basis. Because the assay can be performed currently in any diagnostic laboratory, the researchers believe patients would benefit from its standard use in clinical trials.
It would improve upon current practice by providing biologic tumthe behavior data. Such data might predict well, which drugs would work best in an individual patient.