IMS 2026 | Mass spectrometry for sensitive disease detection and response assessment in multiple myeloma

So this morning I’ve talked about mass spectrometry in the current myeloma framework. So basically mass spectrometry is more sensitive as compared to conventional methods. So at diagnosis we have a new diagnostic window because we know that using mass spectrometry, we are able to diagnose a significantly higher proportion of patients with monoclonal gammopathy. We need to understand what that means, but we are able to identify a monoclonal component in those patients. So then, so once the patient is diagnosed using mass spectrometry, so we can go deeper in the response, in the assessment of the response to treatment, right? Because it’s more sensitive. So basically, so in the group of patients that are immunofixation negative, negative with the conventional methods, mass spectrometry is able to detect the presence of the monoclonal protein in approximately a quarter of patients. And these patients mass spectrometry positive by immunofixation negative do worse in terms of PFS, so more sensitivity and a clinical value, an associated clinical value. So, and then I presented results of mass spectrometry and MRI assessing the bone marrow. So we can get concordant results of double positive or double negative, but we can also get discordant results. So discordant results favoring mass spectrometry can be due to the delayed clearance of the monoclonal protein, they can be due to the presence of extramedullary disease, or they can be due to the fact that sometimes the sample that we use to assess them at the end of bone marrow is not good enough, it’s highly diluted, so that would be a reason for that. And the opposite, that means bone marrow positive and mass spectrometry negative. So it can be due to the higher sensitivity of the marrow techniques as compared to MALDI-TOF-based mass spectrometry, which is the mass spectrometry method that has been tested more extensively as of today. And finally, mass spectrometry is more sensitive as compared to conventional methods. So if we follow our patients with mass spectrometry, we are going to identify progression earlier as compared to conventional methods. We have seen that in our studies and other studies. So we detect progression earlier as compared to immunofixation and we know that these patients progress in a relatively short period of time. So what we don’t know so far is what should we do in these cases that we see conversion to mass spectrometry positive. And I think that could be a summary of the presentation that I gave this morning.

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