Diagnosis and Monitoring Multiple Myeloma | Claudio Cerchione, MD | IMS 2024

There is an ongoing revolution in therapy of multiple meloma. According to many drugs, many combinations, immunotherapy has become the backbone. However, I think that according to the wonderful results that we are seeing in everyday practice, we should particularly care about the importance of correct diagnosis and correct monitoring of our patients. We should focus on diagnostic tools in order to optimize also the treatment that we have available. In my institution, we are completing, evaluating that in terms of imaging, we should combine both PET-CP together with the whole body MRI. In this EMS conference in Rio de Janeiro 2024, we have presented our data in this moment, monocentered, but we are going to enlarge to a national network. And particularly the addition of whole body MRI to PET-CT is doing a difference in the study or rescheduling of our patients in 25% of the population. This is an incredible result. This means that one patient on four changes outcome, changes management, thanks to a careful monitoring. Moreover, I think that also in terms of molecular evaluation of our patients, we should do something more. FISH is currently the worldwide recognized strategy, thanks to which we consider a patient at high risk, intermediate and low risk. And we know this is the historical evaluation that we perform. However, in my institution, we are going to develop a strategy in order to understand which are the biomarkers of response and potentially in order to develop a tailored strategy, a target therapy that is awarded in multiple meloma. We are performing to all our patients newly diagnosed with oral upset refractory, also a later line, Sky 92 panel that correlates cytogenetic with the 92 genes. According to a new molecular approach, we want to understand which are the biomarkers of response in order to optimize the shoes. I think that the real end point of this trial that will be added to new generation imaging that we are performing is to understand which is the correct drug or correct combination because I think that the real unmet medical need is that we have too many drugs, too many combinations, but we don't have in this moment a basis to understand which is the best opportunity for every patient. And I think that this is something that we have to cover and I hope that our data, we are going to show preliminary data. I hope in Ash 2024, we'll also change the idea of maybe a new prognostic score based on molecular approach. And I hope that we will be able to write the term target therapy also next future of multiple meloma because as much as the strategy becoming personalized, I think that we can run more and more to the cure. And this is the best wish that I give to our patients, to all meloma researchers, and to all the families that every day fight against multiple meloma and these relapses that unfortunately are again something that we should definitely defeat.