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ASH 2024 | A novel prognostic system based on circulating tumor cells for newly diagnosed multiple myeloma
Evangelos Terpos, MD, PhD, University of Athens School of Medicine, Athens, Greece, discusses the potential of circulating tumor cells (CTCs) as a prognostic tool in multiple myeloma (MM) and comments on the development of a novel prognostic scoring system that incorporates CTCs into the well-established revised International Staging System (ISS). Prof. Terpos highlights that nearly 90% of patients with newly diagnosed myeloma have detectable CTCs and that a cut-off level of 0.02% has independent prognostic value for both progression-free survival (PFS) and overall survival (OS). Hence, following further validation, this novel scoring system has the potential to provide more accurate prognostication in this patient population. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
I think it’s an interesting oral presentation because what we’ve done in this paper is that we try to include or to incorporate the circulating tumor cells in the already well-established staging systems like the revised ISS. So we had more than 500 patients with newly diagnosed multiple myeloma where we checked them for circulating tumor cells and we’ve seen that in almost 90% of them were able to find circulating tumor cells and the median level of these cells was 0...
I think it’s an interesting oral presentation because what we’ve done in this paper is that we try to include or to incorporate the circulating tumor cells in the already well-established staging systems like the revised ISS. So we had more than 500 patients with newly diagnosed multiple myeloma where we checked them for circulating tumor cells and we’ve seen that in almost 90% of them were able to find circulating tumor cells and the median level of these cells was 0.01%. But if you take a cutoff level of 0.02%, this had an independent prognostic value for survival, for both PFS and overall survival. Based on that, we tried to incorporate circulating tumor cells to the revised ISS and also to the phenotypic staging system that the Spanish group has developed. We give one point for each one of the stages of revised ISS, one, two and three, so it is one, two and three respectively points. We are giving again from the MGUS phenotype to multiple myeloma phenotype of the Spanish staging system one, two and three again and for circulating tumor cells if it is below 0.02% is one point if it is above two points. So we end up with something that the minimum is three and the maximum is eight.
So if we are putting three groups based on this scoring system one, two, three, four, five, six, seven, and eight, if we put them together, then you can find that we can separate fantastically the three groups. So we believe that the circulating tumor cell can offer more prognostic value in the already used prognostic systems like the revised ISS and I believe that the validation of this prognostic scoring system is of great importance and we may do it within the European Myeloma Network.
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Disclosures
Amgen: Honoraria, Other: Travel expenses, Research Funding; AstraZeneca: Honoraria, Other: Travel expenses; BMS: Honoraria; EUSA Pharma: Honoraria, Other: Travel expenses; Janssen: Honoraria, Research Funding; GSK: Honoraria, Research Funding; Menarini/Stemline: Honoraria; Pfizer: Honoraria; Sanofi: Honoraria, Other: Travel expenses, Research Funding; Takeda: Honoraria, Other: Travel expenses, Research Funding; Novartis: Honoraria; Antengene: Honoraria, Research Funding; Swixx: Honoraria.
