Sensitive blood-test as a patient-friendly alternative for bone marrow-based cancer monitoring

Hans Jacobs and Pieter Langerhorst, theme Cancer development and immune defense, worked together with an international team of researchers, led by the Radboudumc and the Erasmus MC. They have developed a novel technique for the ultra-sensitive assessment of minimal residual disease (MRD) in a single drop of blood of patients with multiple myeloma using mass spectrometry.

In the latest edition of Clinical Chemistry they show that their blood-based method performs equally well compared to MRD-evaluation on bone marrow. “Through personalized diagnostics on one drop of blood, we can create a patient-friendly alternative to monitor minimal residual disease in myeloma patients,” says principle investigator Hans Jacobs, who is supported by a KWF grant.

Multiple Myeloma is the second most common hematological malignancy, characterized by cancer plasma cells in the bone marrow. These monoclonal plasma cells produce a patient and cancer specific monoclonal antibody (M-protein), which is used to monitor disease activity. There is not yet a cure for patients with multiple myeloma. However, due to improved treatment strategies an increased percentage of patients reach a state of MRD. In these patients disease load must be measured with invasive bone marrow aspirations because currently there is no method available that is sensitive enough to detect low disease activity in the blood.

The novel method is based on very sensitively measuring the unique patient-specific region of the M-protein by LC-MS/MS in a single drop of blood of patients with multiple myeloma (MS-MRD). In their publication in Clinical Chemistry the researchers showed that MS-MRD is 1000-fold more sensitive compared to current blood-based diagnostics. In a head-to-head comparison of MS-MRD with bone marrow-based MRD evaluation they found that the assays performed equally well to monitor MRD in patients with MM.  The blood-based MS-MRD assay allows continuous MRD-evaluation over time “This opens the possibility to monitor these patients in greater detail, which is crucial for early detection of disease relapse” says PhD candidate Pieter Langerhorst (Dep. Laboratory Medicine). “We have created personalized diagnostics that can make a significant positive impact for myeloma patients. This study is a key step towards the implementation of our blood-based MS-MRD assay”.

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  Cancer development and immune defense