Brian G.M. Durie, MD, chairman, International Myeloma Foundation, hematologist/oncologist, Cedars-Sinai Medical Center, Los Angeles, California, discusses a more sensitive automated flow cytometry minimal residual disease (MRD) test.

Durie says there is an automated flow cytometry MRD test that is nearly ready for commercial use. In order to develop this test, researchers went back to the drawing board and looked at the phenotype of the diverse abnormal plasma cells that are seen in the different forms of myeloma. Based on this, Durie says, the researchers came up with a cocktail of 8 antigens that identify myeloma regardless of its state or location in the body.

In addition to the cocktail, a computer software program was developed so that the read-out is not dependent on an observer. These results are analyzed using a computer algorithm, Durie says, producing an exact print out of the presence or absence of the malignant plasma cells.

Durie says this is an unexpected, major success. The sensitivity of the test is 10-5 and maybe even lower.

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Dr. Durie on a More Sensitive Automated Flow Cytometry MRD Test

Brian G. M. Durie, MD, Cedars-Sinai Medical Center, Senior Advisor, Hematologic Malignancies, National Program Director, Multiple Myeloma and Related Disorders for Aptium Oncology, discusses the impact that novel therapies have made for patients with multiple myeloma.

The most important novel therapies for multiple myeloma are separated into two classes: 1) immunomodulatory agents (IMiDs): thalidomide (Thalomid), lenalidomide (Revlimid), and pomalidomide, which Durie hopes will be approved, and 2) proteasome inhibitors: carfilzomib (Kyprolis) and bortezomib (Velcade).

Survival curves for multiple myeloma were in decline for decades, Durie says, are steadily coming up. Today, 56% of patients over 65 are living for five years while 70% of patients under 65 are living for five years. It is because of novel therapies that such significant strides have been made from a time when survival was two to three years.

The question in multiple myeloma is how can the steps towards longer survival be translated into steps towards a cure. Focus remains on patients with good prognosis and improved treatment combinations, Durie says, but there is a need for new therapies in aggressive disease.

Brian G. M. Durie, MD, Cedars-Sinai Medical Center, Senior Advisor, Hematologic Malignancies, National Program Director, Multiple Myeloma and Related Disorders for Aptium Oncology, discusses novel therapies for multiple myeloma.

Brian G. M. Durie, MD

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Dr. Durie on a More Sensitive Automated Flow Cytometry MRD Test

Dr. Brian Durie on Novel Therapies in Multiple Myeloma