IMS 2026 | Mass spectrometry monitoring with the Binding Site EXENT analyzer in multiple myeloma

So we have seen a number of really exciting developments not only in the treatment of myeloma but also in the monitoring and diagnostics of myeloma. One of these tools that we now have available as a clinically accredited test is mass spectrometry and one of the providers is for example the EXENT system by the Binding Site. This is really a huge step forward. It is measuring the ultimate paraprotein that we have traditionally measured, but it does it differently in two ways. So the first difference is that through the more precise measurement, actually, we can track the disease in a personalized fashion. The paraprotein measurement was a relatively old method that was developed in the last century still. Whereas here, we can define the exact, effectively, size of the paraprotein of an individual patient, and that allows a personalized and much more precise tracking. That’s the second aspect of it, that the sensitivity of this measurement is about 10 to 20 times higher than the traditional paraprotein measurement. So that means we can use this tool in our practice. The highest value is really for patients that have gone into a deep remission when the paraprotein is gone. We have to have a baseline assessment before they start treatment. But once they are at that low level, we know that the need for patients to have treatment-free intervals is increasing with the new treatments. At the same time, once treatment could be stopped, which many patients now ask for, they probably want to have a monitoring that reassures them that in that time they’re off treatment, the disease doesn’t very suddenly come back at a high level. So the XN system, for example, allows us to track that disease at a very, very low level so that even resurgence at a level that is not clinically relevant could be picked up well before the paraprotein comes back. And that can, of course, in the future give new opportunities. It could give on an individual patient basis potentially the opportunity to maybe restart a treatment if a patient opted for having a treatment break. I personally am a big believer in that we should empower patients more to have a joint decision-making process and a patient preference process on this, given that our treatments are so good. And it could also, on a more global level, potentially redefine relapse in the future. We might actually see it as a tool helping clinical development for new drugs as they get better over time as it could pick up resurgence of the disease earlier.

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