Monitoring minimal residual disease in patients with multiple myeloma by targeted tracking serum M-protein using mass spectrometry (EasyM)

• Published in: Clinical cancer research 2024-03, Vol.30 (6), p.1131-1142
• Main Authors: Fan, Huishou, Wang, Bing, Shi, Lihui, Pan, Ni, Yan, Wenqiang, Xu, Jingyu, Gong, Lixin, Li, Lingna, Liu, Yuntong, Du, Chenxing, Cui, Jian, Zhu, Guoqing, Deng, Shuhui, Sui, Weiwei, Xu, Yan, Yi, Shuhua, Hao, Mu, Zou, Dehui, Chen, Xiequn, Qiu, Lugui, An, Gang
• Format: Article
• Language: English
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-23-2767

We investigated both the clinical utilities and the prognostic impacts of the clonotypic peptide mass spectrometry (MS)-EasyM, a blood-based minimal residual disease (MRD) monitoring protocol in multiple myeloma (MM). 447 sequential serum samples from 56 MM patients were analyzed using EasyM. Patient-specific M-protein peptides were sequenced from diagnostic sample; sequential samples were quantified by EasyM to monitor the M-protein. The performance of EasyM was compared with serum immunofixation electrophoresis (IFE), bone marrow multiparameter flow cytometry (MFC), and next-generation flow cytometry (NGF) detection. The optimal balance of EasyM sensitivity/specificity versus NGF (10-5 sensitivity) was determined and the prognostic impact of MS-MRD status was investigated. Of the 447 serum samples detected and measured by EasyM, 397, 126, and 92 had time-matching results for comparison with serum IFE, MFC-MRD, and NGF-MRD, respectively. Using a dotp >0.9 as the MS-MRD positive , sensitivity was 99.6% vs. IFE and 100.0% vs. MFC and NGF. Using an MS negative cutoff informed by ROC analysis (