New test detects return of blood cancer a year earlier Measurement is a thousand times more sensitive than current standard test

A new blood test can detect the return of multiple myeloma, a type of blood cancer, a year earlier than the current standard blood test. The developed measurement is a thousand times more sensitive. This is the result of a study by Radboud university medical center involving forty patients. The clinical implications of the new measurement are not yet known.

Multiple myeloma, also known as Kahler's disease, is a blood cancer that originates in the bone marrow. It involves uncontrolled division of a certain type of white blood cell, the plasma cell. Approximately 1,300 people in the Netherlands are diagnosed with this disease each year. Half of the patients respond so well to treatment that the disease becomes undetectable in their blood. Unfortunately, the disease almost always returns.

To determine when the disease returns, the standard test currently involves a biopsy from the bone marrow . This is an invasive method and therefore cannot be performed regularly. Moreover, the result is not entirely reliable as it depends on where the biopsy is taken, because the disease is not present throughout the bone marrow. There is also a blood test available, but it is much less sensitive, only detecting the cancer's return when the number of cancer cells is already high.

Better Monitoring

Researchers from Radboudumc, in collaboration with colleagues from Erasmus MC, have developed a new blood test that is a thousand times more sensitive than the current blood test. In a study with forty patients, they demonstrated that their test could detect an increase in cancer cells a year earlier compared to the current standard blood test. The new test requires less than a drop of blood.

‘Patients whose disease is no longer measurable after treatment often live in uncertainty for years’, says Hans Jacobs, Medical Immunologist. ‘With the new blood test, you can monitor much better, providing clarity. When the current blood test shows the cancer's return, the number of cancer cells is already high, and a different therapy is initiated. With the new test, we see the increase in cancer cells much earlier. This may allow for quicker and better adaptation of therapy to the patient’s situation, but we don’t know that yet. We will investigate this.’

Smart Adjustment

The new blood test measures antibodies produced by plasma cells, which play an important role in immunity. ‘Healthy people have plasma cells with various types of antibodies ready to tackle different pathogens’, explains researcher Hans Wessels. ‘In multiple myeloma, one of these cells divides uncontrollably, creating many plasma cells with the same antibodies. These are what we measure with the new test.’

Initially, developing the test for each specific patient took 125 days. Now, a smarter method has been developed that is suitable for every patient and can test 25 patients simultaneously. With these improvements, test development now takes only five days, allowing many more patients to be tested. Additionally, researchers, together with the company Bruker, developed new software that can smartly adjust the measurement, allowing the test to detect tumor cell signals even faster.

Finger Prick

The new test is not yet available in the clinic. ‘We first need ISO certification for this’, says Professor of Personalized Healthcare Alain van Gool. ‘We aim to achieve this in the coming years. Until then, we will only perform this test in clinical studies.’ Meanwhile, researchers are investigating whether their method also works reliably when people collect a drop of blood at home using a finger prick. This would eliminate the need for patients to visit the hospital for blood collection, representing a further step in a series of innovations.

The described blood test is not yet available in the clinic, only within clinical studies. Voluntary enrollment in these studies is not possible. Radboudumc selects patients based on inclusion and exclusion criteria.

About the Publications

The collaborative project EnFORCE (LSHM 21032) is co-funded by the PPP  allowance provided by Health~Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships. This research was also funded by KWF. The described results are published in:

• Clinical Chemistry Laboratory Medicine Journal: An automated workflow based on data independent acquisition for practical and high-throughput personalized assay development and minimal residual disease monitoring in multiple myeloma patients. Charissa Wijnands, Gad Armony, Somayya Noori, Jolein Gloerich, Vincent Bonifay, Hélène Caillon, Theo M. Luider, Sven Brehmer, Lennard Pfennig, Tharan Srikumar, Dennis Trede, Gary Kruppa, Thomas Dejoie, Martijn M. VanDuijn, Alain J. van Gool, Joannes F.M. Jacobs, Hans J.C.T Wessels. DOI: 10.1515/cclm-2024-0306 
• Clinical Chemistry Laboratory Medicine Journal: M-protein diagnostics in multiple myeloma patients using ultra-sensitive targeted mass spectrometry and an off-the-shelf calibrator. Charissa Wijnands, Pieter Langerhorst, Somayya Noori, Jenneke Keizer-Garritsen, Hans J.C.T. Wessels, Jolein Gloerich, Vincent Bonifay, Hélène Caillon, Theo M. Luider, Alain J. van Gool, Thomas Dejoie, Martijn M. van Duijn, Joannes F.M. Jacobs. DOI: 10.1515/cclm-2023-0781 
• Blood Cancer Journal: Dynamic monitoring of myeloma minimal residual disease with targeted mass spectrometry. Somayya Noori, Charissa Wijnands, Pieter Langerhorst, Vincent Bonifay, Christoph Stingl, Cyrille Touzeau, Jill Corre, Aurore Perrot, Philippe Moreau, Hélène Caillon, Theo M. Luider, Thomas Dejoie, Joannes F. M. Jacobs, and Martijn M. van Duijn. DOI: 10.1038/s41408-023-00803-z

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