BCMA: A new biomarker for multiple myeloma

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Published: 25 Sep 2019
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Dr James Berenson - Oncotherapeutics, West Hollywood, USA

Dr James Berenson talks to ecancer at the International Myeloma Workshop 2019 about BCMA or B-cell maturation antigen.

This is a novel marker for multiple myeloma which will improve the speed at which changes in clinical status can be determined, and is also a good prognostic marker.

The benefits of this marker therefore allow patients to move quickly away from a regimen that isn't working, or begin with less treatment.

Dr Berenson predicts that we could establish a threshold for the amount of BCMA in a patient which provides an accurate level of risk for developing myeloma.
 

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

Over the last several years we have identified a new biomarker for tracking multiple myeloma. It’s called BCL maturation antigen, or BCMA. We have demonstrated that this marker is a much quicker way to find changes in clinical status in myeloma and also is an excellent prognostic marker. We’ve recently also identified that this marker can predict who with pre-myeloma or MGUS can get myeloma and which among the smouldering myeloma patients may be at risk to become active and need treatment. The exciting data is that because this marker or protein turns over every day it has a much quicker ability to see a difference in that patient’s clinical status. So we can pick up patients that are progressing, getting worse, much more rapidly than the currently available markers which are the monoclonal antibodies which take many weeks for that to happen. This is really good news because then patients don’t have to stay on a treatment that may not be working and can change quickly. It may also ultimately allow them to start with less treatment and only need the addition of other drugs or changes should there be a rise because we’re not going to wait until patients get clinically sick, we’re going to know a lot earlier what’s going on.

It also may allow us to identify patients that may be good candidates for certain treatments. We don’t know that with certainty at this point, we’re trying to find that out. But we know that baseline levels highly predict your ability to respond and your progression free survival. Now, also the data recently generated in, again, pre-myeloma tells us that we may be able to establish a threshold that is a level of BCMA. If you’re above that level you’re at risk and if you’re below you may not be at any risk to develop myeloma and similarly in smouldering myeloma. We need a lot more work to show that’s true.

Last but not least we’ve also shown that among patients with myeloma who receive treatment that if they actually get to a level below about 82ng/ml, which is below the upper limits of normal, they have an extremely good prognosis compared to those that do not. Our initial data suggests that that marker may tell you that, even among patients who don’t have complete elimination of the myeloma.

So we’re very excited about this marker in myeloma. Also we have similar data now in chronic lymphocytic leukaemia; we’re generating data in amyloidosis now as well as Waldenstrom’s macroglobulinemia. So this is a nifty marker, it’s very easy to do the test. It only requires less than a drop of blood to do this test and it’s very stable at room temperature so it’s convenient to ship, convenient to do. So we hope to generate a lot more data from a lot of clinical trials, substantiating the data we’ve seen to date over the last few years.