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Serum BCMA for Myeloma Diagnosis

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Diagnostic testing for multiple myeloma has come along way over the past decade. Improvements in diagnostic testing is one of the reasons why MM patients are living so much longer now. And now serum BCMA for myeloma diagnosis and prognosis may be another step forward.

Though the article linked below with MM specialist Dr. James Berenson, is far reaching, I have edited this the interview with Dr. Berenson to focus on serum BCMA for myeloma diagnosis in general and how this diagnostic marker can help MM patients undergo less chemotherapy and therefore experience less toxicity.



I chose to edit the interview below because Dr. Berenson uses phrases that I am not used to reading in interviews with all other oncologists. Phrases such as:

  • take patients off therapy more confidently…
  • give them a drug holiday…
  • in the future is that it’s going to allow us to maybe tap down some of the therapies, give less drugs, and/or maybe lower doses…

My take on the interview linked below is that Dr. Berenson sees serum BCMA for myeloma diagnosis as a way to give MM patients less toxicity not more. And this makes sense to me because Dr. Berenson is the only MM specialist who openly disagrees with autologous stem cell transplantation.

Further, Dr. Berenson has the highest 5 and 10 year survival statistics of any MM specialist that I know of. 

I hope to research and write more about serum BCMA for myeloma diagnosis in the future. The idea of a diagnostic marker used to give less chemo is almost too good to be true.

I am a long-term myeloma survivor. I have learned a lot about the good, the bad and the ugly about MM. Email me at David.PeopleBeatingCancer@gmail.com to learn more about both conventional and non-conventional myeloma theories.

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Serum BCMA May Help Predict Outcomes, Monitor Disease in Multiple Myeloma

“Serum BCMA may be the way forward not only as a disease-monitoring tool in patients with multiple myeloma but as a way to predict outcomes in select populations, explained James R. Berenson, MD.

“Not only is it a marker of prognosis and predictability; it is also an excellent way to monitor the disease. It has several advantages over the conventional markers, which are the monoclonal immunoglobulin and the so-called M protein that’s spewed out of the myeloma cell, which can be in a full form—what we call light chains,” Berenson said. “Those markers are traditionally how we follow myeloma…’

Using serum BCMA to get these answers for individual patients could also help determine if breaks in therapy or treatment holidays are possible for them, he added…

How is BCMA currently used in practice?

BCMA is the target of several new immune-based therapies involving what are called bispecific antibodies targeting BCMA and the immune T cells that are the type of cells that kill myeloma. There are also T-cell therapies in which specific vectors are put into the T cells to allow them to target BCMA.

They also activate to kill BCMA-containing cells, which are the plasma cells—not only the malignant cells but the normal plasma cells. There’s a fair bit going on [over] the last several years, and it’s growing in stature, as we see how effective it is in terms of soluble serum BCMA.

Diving into serum BCMA, what is the story there?

It turns out that BCMA is shed off the myeloma cells, like scissors cutting a string. The string sticking out of the cell then goes into the blood; you can measure it.The protein that specifically does that is γ-Secretase. When that’s shed in the blood, you can measure it quite easily. The amount of BCMA blood correlates with the amount of plasma cells in the patient, and that includes, in myeloma, mostly malignant plasma cells.

How is serum BCMA going to be best used in the clinic?

For more than the past decade, BCMA is much higher in patients with myeloma than in normal individuals or healthy [patients]…

In addition, we know that the levels of BCMA do predict your chances of responding and how long you’re going to respond for. We also are embarking now in a large trial involving one of the drugs that we have been studying over the last several years of the JAK inhibitor ruxolitinib [Jakafi]. It appears that BCMA is quite good at predicting who is going to respond to that drug. We don’t have the final data on that [yet], but it looks pretty much that way, and soon should be sending that in for publication…

The additional advantage, however, with BCMA is that it is a much more rapid way to assess changes in clinical status. If you follow the patient’s M protein…BCMA is kind of like getting a message by email; it’s much more rapid…

What is that good for? If you can find the patient’s disease is worsening more rapidly, that’s big because that means you can take the patient off ineffective therapy more rapidly and get them onto something that would hopefully be better. It also avoids the toxicity that they might be getting from therapy that’s not working.

The big advantage in the future is that it’s going to allow us to maybe tap down some of the therapies, give less drugs, and/or maybe lower doses, because you’re going to know very quickly whether these things are working or whether the patient’s disease is worsening…

Now, with BCMA, we can do this more rapidly, and we think that will then certainly optimize the ability to boost the response by adding lenalidomide to somebody who may be [progressing on] ruxolitinib. It’s going to be a big advantage for patient care…”

 

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