The Unknown Patient quickly showered, shaved and dressed and headed off to the evening meeting called by the IMF to have the International Working Committee discuss two exciting, new projects: the International Prognostic Indicators and Bank On A Cure.
The meeting was very well attended, with over forty distinguished scientists powering through their jet lag to engage in a healthy, constructive discussion aimed at sanity checking and fine-tuning these very important efforts.
The International Prognostic Indicator project was launched to develop a new staging system to replace the stalwart, but decades-old Durie-Salmon staging system. Staging systems are important in helping to segment the patient population to better understand the effectiveness of treatment strategies, particularly clinical trials. They also provide a reference point for physicians in beggining to narrow down the treatment options appropriate for an individual patient.
Dr. Philip Greipp(left), who is leading this project, presented the findings and recommendations to the group. The project represents a cooperative effort bringing together data on 11,000 patients from leading cancer treatment and research centers in 20 countries. Statistical analysis was performed on half of the patients' data, looking at which factors are most useful in predicting survival.. Surprisingly, while there were many data elements available for each of the patients, including sophisticated molecular analyses performed on bone marrow samples, two simple blood protein readings, which can be taken using a single blood draw, emerge as the most powerful predictors: These two tests are beta-2 microglobulin (β2m) and serum albumin.
The new stages are defined as follows::
- β2m less than 3.5, Albumin greater than or equal to 3.5
- β2m less than 3.5, Albumin less than 3.5
or β2m between 3.5 and 5.5
- β2m greater than 5.5
The analysis also investigated factors identifying risk levels for myeloma patients. Forgive your Unknown friend for not chronicaling the details of this part of the presentation, but it had been a very long day. The IMF has told me that it will soon be publishing the details in Myeloma Today and on the web site.
Next up was Dr. Brian Van Ness, to introduce the discussion of Bank On A Cure. Dr. Van Ness is leading this project along with Dr. Gareth Morgan. Bank On A Cure is an international effort which is already underway, seeking to collect 20,000 DNA samples from myeloma patients and healthy controls, including family members. These samples would then be available for analysis by the international scientific community for research into important issues. These issues include, for example, understanding the causes of myeloma, predicting which patients will respond to specific treatments, and identifying targets for new treatment approaches. The Unknown Patient was thrilled to hear about the progress made thus far on this important project. 1200 samples have been collected thus far, and an impressive list of scientists and institutions around the world are signing up to participate. Proctor and Gamble has signed up as the first corporate donor. And, a very generous private donor made a gift that allowed the IMF to jump-start the effort. Again, please forgive your Unknown friend for not having more of the details documented here. But, stay tuned. There will be updates in Myeloma Today, the Myeloma Minute and on the web site.
Please note that the Unknown Patient is a patient, not a doctor and not a scientist. This summary represents a layman's view of what was said at the conference and should form a basis for raising awareness of issues that could be discussed with a qualified professional. In no way should anything contained in this report be taken as medical advice or form the basis for action without first consulting a qualified medical professional who is familiar with your specific medical situation.