My name is Irene Ghobrial.
I'm a professor of medicine at Dana-Farber Cancer Institute, and I'm just excited today to talk about the Promise study.
We are presenting it at the American Society of Hematology in 2025.
Promise started several years ago with the idea: can we screen for people at risk for multiple myeloma?
We know that many of us, by the age of 40 or 50, have about a 3 to 5% chance of developing multiple myeloma or monoclonal gammopathy, which is MGUS, based on the original data from Mayo Clinic, but also based on the iStopMM study from Iceland.
Now, we wanted to ask the question: what about the rest of the U.S. population? What about diverse people? How about people of African descent, African Americans, as well as people with a very strong family history?
If my brother had multiple myeloma, or my sister, or my mom and dad, will I be at risk?
And we said that we will screen people who are at risk, meaning either of African descent or African Americans, or people who have a strong family history of multiple myeloma or other blood cancers.
Originally, we started in the United States and it was direct-to-patient.
So you can get a QR code and just go and get your blood test sample, and we will call you back if your results are positive.
And if you're negative, we rescreen you again in three years.
Then we opened it in South Africa, and we also accrued in Israel and Greece.
And then we decided to also look at populations that also prospectively screened people.
So the PLCO study, which was screening people in general in the United States to look for lung cancer or prostate cancer, had samples that we could access, as well as what we have in the area of Mass General Brigham, which is called the Mass General Brigham Screening Study or Health Biobank Study, where we were seeing patients in our hospitals in New England, and we were getting their samples collected, and we have all their medical records.
By doing that, we are now presenting over 30,000 patients who screened with us.
And we have their samples done by MALDI-TOF, which is the mass spectrometry from Binding Site.
We used a new cutoff that is now FDA approved for immunoglobulins.
So we're not presenting today the lower monoclonal gammopathy that we've shown before, which actually is another oral presentation for the monoclonal gammopathy of indeterminate potential, or MGIP, which is the earlier setting before MGUS.
With the 33,000 population that we have now, we found that we have about a 14% prevalence for African-American or people of African descent.
And that's a very high number compared to the 3 to 5% that we've seen in other populations.
And in the family history, we found that indeed it's still very high, especially if you have two family members with multiple myeloma or with a plasma cell disorder, not other blood cancers.
We're now expanding our understanding of who are truly those patients at risk by doing germline sequencing.
But we also looked using the iStop calculator at how many of those people have smoldering myeloma, or potentially would have smoldering myeloma, because we don't have a bone marrow biopsy for everyone.
And indeed, we found almost 3% of those people of African-American or African descent may have smoldering myeloma.
So it's a higher chance of developing it compared to the general population.
That's huge for us because now we can ask the question: are those the patients who are eligible for trials, like daratumumab, that is commercially available now, but also other clinical trials for smoldering myeloma?
And that could help us in screening early, but intercepting early our patients.
We’re moving on to try and ask those questions. Indeed, can we screen and then intercept people?
And the most critical piece, which is the last part, we looked at progression in the larger cohorts that we had from MGP and PLCO, and we found in the African American population and people with family history had the higher risk of progression compared to the control population, which is the white population with no high-risk features.
All of this together tells us that indeed, we should likely be screening people, especially at-risk populations.
And maybe that's the future for us—to intercept, especially with drugs that are already approved.
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HealthTree • December 18, 2025