ASH 2021 | CTC assessment in smoldering and active multiple myeloma is clinically valuable

Juan José Garcés, MD, University of Navarra, University Clinic of Navarra, Pamplona, Spain, gives an overview of the findings of a study investigating the clinical significance of circulating tumor cells (CTCs) in patients with smoldering multiple myeloma (SMM), newly diagnosed, and relapsed/refractory (R/R) multiple myeloma. Results from over 1000 patients showed that CTCs were detectable in the majority of patients and high CTC levels were associated with worse prognosis in all disease settings, in particular in transplant-ineligible patients with newly diagnosed multiple myeloma. CTC levels were shown to have independent prognostic value in SMM and newly diagnosed myeloma. High CTC levels were associated with an ultra-high transformation risk in patients with SMM. Importantly, early intervention in patients with SMM and achievement of undetectable measurable residual disease (MRD) in patients with newly diagnosed multiple myeloma were shown to abrogate the poor prognosis of high CTC levels in those patients. These observations suggest that CTCs represent a powerful marker of malignant transformation and disease aggressiveness and should be included in the multiple myeloma diagnostic workup. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.