A liquid biopsy for myeloma may be closer than we think! Excited to share our work on MRD in the peripheral blood using mass spectrometry! We found mass spec may exceed the sensitivity of bone marrow based methods w/superior prognostication #mmsm #mmMRD http://bit.ly/MRDmyeloma 

What we found is:
1) Many cases were mass spec (+) and NGS (-).
2) Mass spec pos. predicted conversion of NGS(-) to (+)
3) Mass spec was superior prognosticator to NGS (10^-5-10^-6) in a small cohort.
#mmsm #mmMRD /2
https://cancercommunity.nature.com/posts/mass-spectrometry-is-a-highly-sensitive-peripheral-blood-marker-for-minimal-residual-disease-in-multiple-myeloma

Mass spec looks for the protein product at a heightened sensitivity vs. SPEP/IFIX. We wanted to know if mass spectrometry performed on peripheral blood samples of patients uniformly treated w/ KRd & ASCT on a phase 2 study could approximate high sensitivity bone marrow assays /3

We performed mass spec by 2 methods: MALDI-TOF and liquid chromatography-MS.
We also performed MRD by NGS in the bone marrow (Limit of detection <10^-5), PET/CT, and flow in most patients.
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The potential downfall with mass spec is that it picks up monoclonal protein even after the disease is eradicated due to immunoglobulin recycling! So we decided to perform mass spec on samples very far out from diagnosis (nearly 2 and 3 years for most patients) & compare w/NGS /5