Non-invasive MRD Assessment in Multiple Myeloma

Overview

The purpose of this study is to investigate the sensitivity and accuracy of non-invasive MRD assessment using liquid biopsy (blood draw) and functional imaging (whole body MRI) in participants with new diagnosed and previously treated multiple myeloma. The long-term goal of this study is to investigate whether non-invasive methods for MRD assessment can replace bone marrow aspiration and biopsy in a substantial percentage of participants with multiple myeloma.

Full Title of Study: “Non-Invasive Minimal Residual Disease (MRD) Assessment in Multiple Myeloma Via Functional Imaging and Liquid Biopsy”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: September 2024

Detailed Description

There is an unmet clinical need for an easier, non-invasive, and reliable method to perform MRD assessments that can be used in clinical trials and routine practice. The two non-invasive modalities that are most promising for MRD assessment are liquid biopsy to detect circulating tumor cells (CTCs) and functional imaging to detect focal myeloma lesions. However, there are no prospective data on the sensitivity and specificity of non-invasive MRD assessment with respect to the gold standard of bone marrow sampling.

Interventions

  • Other: MRD Assessment
    • MRD assessment includes liquid biopsy and functional imaging. Liquid biopsy will be performed by the Adaptive ClonoSEQ® assay in peripheral blood. Functional imaging will be performed by whole body diffusion-weighted magnetic resonance imaging (WB-DWI).

Arms, Groups and Cohorts

  • Myeloma Group
    • Patients with newly diagnosed and previously treated multiple myeloma will receive bone marrow sampling and functional imaging.

Clinical Trial Outcome Measures

Primary Measures

  • Sensitivity of non-invasive MRD assessment
    • Time Frame: 6 months
    • MRD assessment includes liquid biopsy and functional imaging.
  • Specificity of non-invasive MRD assessment
    • Time Frame: 6 months
    • MRD assessment includes liquid biopsy and functional imaging.

Secondary Measures

  • Sensitivity of two MRD-testing algorithms
    • Time Frame: 6 months
    • Combining liquid biopsy, functional imaging, and bone marrow sampling against the reference of bone marrow sampling in patients
  • Specificity of two MRD-testing algorithms
    • Time Frame: 6 months
    • Combining liquid biopsy, functional imaging, and bone marrow sampling against the reference of bone marrow sampling in patients
  • Progression Free Survival
    • Time Frame: 2 years
    • The progression-free survival (PFS) will be calculated of patients who are MRD-positive and MRD-negative on each modality (liquid biopsy, functional imaging, and bone marrow sampling)
  • Overall Survival
    • Time Frame: 2 years
    • The overall survival (OS) will be calculated of patients who are MRD-positive and MRD-negative on each modality (liquid biopsy, functional imaging, and bone marrow sampling)

Participating in This Clinical Trial

Inclusion Criteria

  • Adults age ≥18 years – Patients with newly diagnosed multiple myeloma – Patients with previously treated multiple myeloma with a maximum of two prior lines of therapy – Expected life expectancy of greater than one year and intention to start a new line of treatment Exclusion Criteria:

  • Patients without cognitive capacity to give informed consent for participation – Patients with contraindications to MRI, which include the following: – Claustrophobia, which, at investigator's discretion, would prohibit patient from undergoing whole body diffusion-weighted magnetic resonance imaging (WB-DWI) – Pacemaker – Metallic implants, which would prohibit patient from undergoing MRI All subjects will be screened for any contraindication to MRI as per their guidelines at the time of patient enrollment. – Patients must not receive granulocyte colony stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) injection within 1 week prior to WB-DWI. – Patients must not have been initiated on treatment prior to baseline disease assessment by bone marrow aspiration/biopsy and/or WB-DWI Up to 160 mg of dexamethasone (or equivalent) and/or 1 dose of bortezomib (+/- Cyclophosphamide-Dexamethasone) is allowed prior to disease assessment by bone marrow aspiration and WB-DWI.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Rajshekhar Chakraborty, MD
  • Collaborator
    • Hope Foundation
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Rajshekhar Chakraborty, MD, Assistant Professor of Medicine – Columbia University
  • Overall Official(s)
    • Chakraborty Chakraborty, MD, Principal Investigator, Columbia University
  • Overall Contact(s)
    • Research Nurse Navigator, 212-342-5162, cancerclinicaltrials@cumc.columbia.edu

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