First Large-Scale Screening Aims to Prevent Myeloma Before Onset

A screening study — the largest of its kind for myeloma — hopes to find a way to prevent myeloma before it develops. The study, called iStopMM (Iceland Screens Treats or Prevents Multiple Myeloma), was announced by the International Myeloma Foundation (IMF), which is funding the research.

The organization is the largest and oldest in the world to focus on improving the lives of myeloma patients while working to prevent and cure the disease. The screening study will include examination of blood samples from about 140,000 adults over age 40 in Iceland for the earliest signs of myeloma.

“We are incredibly pleased to support the iStopMM project because we strongly believe that early treatment strategies could lead to the cure for myeloma,” said IMF Chairman and co-founder Dr. Brian Durie, who leads the IMF’s Black Swan Research Initiative, a collaborative project focused on finding a pathway to a cure for myeloma. The initiative currently supports more than 35 myeloma research efforts around the world.

About 90,000 people in the U.S. and more than 200,000 people around the world have multiple myeloma, which can remain undiagnosed until advanced stages.

Iceland is considered ideal for the screening study because nearly all citizens there over the age of 40 undergo routine blood tests.

The first step is to collect informed consent, which will take place over the next few months. Then a team led by Dr. Sigurdur Kristinsson of the University of Iceland will screen blood samples from about 140,000 people to search for the precursors to myeloma called monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma.

The study’s initial screening phase will be performed by the U.K.-based producer of diagnostic assays, Binding Site, using Freelite immunoassays and automated electrophoresis testing equipment.

The study’s study’s co-principal investigator is Dr. Ola Landgren, chief of Myeloma Service at Memorial Sloan Kettering Cancer Center in New York City.  Landgren and his team will make a molecular characterization of MGUS cases based on DNA sequencing of abnormal plasma cells in the bone marrow.

In a later stage, individuals who are diagnosed with precursors to myeloma will be invited to participate in a randomized clinical trial to find the best treatment strategy and to create a new risk model for disease progression.

“The IMF is excited to fund this study, which will finally shed light on how we can stop myeloma at its earliest stage before it progresses into full-blown cancer,” said IMF President and co-founder Susie Novis Durie.

According to the foundation, about 4 percent of all people older than 50 have MGUS, but most cases are never diagnosed. “The impact of early diagnosis in a whole population is a very ambitious and challenging goal,” Kristinsson said. “With more potent therapies available with fewer side effects, it is very likely that treatment of precursor states will be shown to improve survival and quality of life in smoldering and MGUS patients.”