BCMA Serum Displays Monitoring Advantages vs Conventional Biomarkers

CancerNetwork® spoke with James R. Berenson, MD, founder, medical and scientific director, and president and chief executive officer of the Institute for Myeloma and Bone Cancer Research, and private practitioner in West Hollywood, California, about advantages BCMA offers in monitoring myeloma progression over conventional biomarkers.

Berenson began by highlighting the multiple uses of BCMA testing as a means of prognosis, predictability, and monitoring disease status. To convey this, he first described the conventional biomarker, monoclonal immunoglobin (M protein), before suggesting that its use requires the presence of a biomarker, something BCMA testing does not require.

He further emphasized that testing with BCMA may eliminate the need to undergo bone marrow assessments or PET scans, which may offer complications and less convenience. Berenson iterated that BCMA level has a parallel tracking to the M protein, making it useful for use in patients with myeloma.

Transcript:

Not only is [BCMA] a marker of prognosis and predictability; it is also an excellent way to monitor the disease. It has several advantages over the conventional markers, which are the monoclonal immunoglobulin, the so-called M protein that is spewed out of the myeloma cell, which can be in a full form—the monoclonal protein—or what we call light chains. Those markers are traditionally how we follow myeloma. The problem is, over time, several patients at baseline have no marker, so you cannot track them with these conventional markers.

Now, we have a marker we know we can do that with, and that is a huge advantage. Formerly, these patients had to have frequent bone marrow [assessments]. That is no fun. They had to have PET scans, which are expensive and have some radioactivity to them. Now, they can avoid that and have a simple blood test to track their disease. We know in patients with conventional markers, there is a parallel tracking of the serum BCMA level to the M protein in those who have an M protein to track, and serum-free light chain for those who have that marker to track.

The additional advantage, however, of BCMA is a much more rapid way to assess changes in clinical status. What do I mean by that? If you follow the patient‘s M protein, as one of my patients said, it is like the Pony Express, whereas BCMA is like getting a message by email. It is much more rapid. We know why that is true now; it’s because it sheds off the cell much more rapidly than the traditional M protein.

We also know that the turnover of the protein is quick. It is 10 to 20 times quicker than the turnover of the conventional M protein. You have a quicker turnover and faster shed, which means you can get a quicker read on whether the disease is getting worse or better.