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COMy 2026 | Insights into the updated genomic consensus definition for high-risk newly diagnosed myeloma
Pieter Sonneveld, MD, PhD, Erasmus MC, Rotterdam, The Netherlands, discusses how the new genomic consensus definition of high-risk newly diagnosed multiple myeloma (MM) may impact clinical practice. Prof. Sonneveld explains that broader molecular profiling approaches may improve the sensitivity and accuracy of detecting high-risk cytogenetic abnormalities beyond conventional FISH testing, and highlights post hoc analyses from the Phase III PERSEUS trial (NCT03710603) suggesting that this approach may significantly influence treatment outcomes. This interview took place at the 12th World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
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Transcript
The International Myeloma Society has organized this meeting to define a new standard for high-risk multiple myeloma based not only on the clinical variables, as we did in the past, but also on a more extensive analysis of the cytogenetic abnormalities, not only by FISH, so fluorescence in situ hybridization, but also by molecular analysis. For example, one of the worst abnormalities for high-risk myeloma is the TP53 mutation...
The International Myeloma Society has organized this meeting to define a new standard for high-risk multiple myeloma based not only on the clinical variables, as we did in the past, but also on a more extensive analysis of the cytogenetic abnormalities, not only by FISH, so fluorescence in situ hybridization, but also by molecular analysis. For example, one of the worst abnormalities for high-risk myeloma is the TP53 mutation. And this is present in about up to 10% of the patients. You cannot catch this by FISH. So we have to do that with molecular methods. And the molecular method is very precise and very sensitive, but also difficult to organize. And the same is true for some abnormalities of 1p, chromosome 1p. So we have to work on new ways to organize this for our patients in the routine clinical practice. It has already been done in prospective clinical trials. For example, in the PERSEUS trials, we have done this analysis after the trial was concluded. And there we see that the impact may be significant on the outcome of treatment. So I argue in favor of doing this molecular analysis in all newly diagnosed patients with multiple myeloma.
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