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BCMA Biomarker Predicts Outcomes in Multiple Myeloma Patients

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Published on March 5, 2020

Key Takeaways

  • B-cell maturation antigen (BCMA) is a protein that has emerged as an effective biomarker for multiple myeloma.
  • Patients with a low level of BCMA at the time of diagnosis are likely to respond well to treatment and have positive outcomes.
  • BCMA detects disease response and progression much more rapidly than conventional markers.

“We can find responses, and probably more importantly, progressive disease much more rapidly than we can with conventional markers,” says Dr. James Berenson, explaining the emergence of BCMA as a reliable and effective biomarker for multiple myeloma. Dr. Berenson, the Medical & Scientific Director at the Institute for Myeloma and Bone Cancer Research, also explains how a patient’s BCMA levels at the time of diagnosis can predict outcomes. Watch now to learn from a leading myeloma expert.  

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Transcript | BCMA Biomarker Predicts Outcomes in Multiple Myeloma Patients

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:         

Hello and welcome to Patient Power. Once again, we’re with a world-renowned myeloma expert, Dr. James Berenson in Los Angeles. Dr. Berenson, you’ve talked to me before about a biomarker BCMA. Remind us what it is, and what’s the latest?

Dr. Berenson:            

So, we have uncovered a new way to track myeloma patients, and that’s a protein that’s a target. A lot of the immune-based therapies with antibodies, antibody drug conjugates, what are called bi-specific T-cell engagers, and CAR-T cells. And that target is a protein called BCMA. And that sticks on the cell surface of myeloma tumor cells or plasma cells. But we learned a number of years ago it’s shed in the blood. And quite to our surprise, we learned that people with really aggressive myeloma had really high levels, and people who had good remissions had much lower levels. And that led us to studying now nearly 20,000 samples on about 1,000 myeloma patients.

And what we’ve learned is the following: The baseline levels highly predict outcomes and likelihood to response to drugs. Secondly, the drops in BCMA occur much more rapidly than they do with M protein or free light chain. So, we can find responses, and probably more importantly, progressive disease much more rapidly than you can with conventional markers. So, you don’t have to stay on therapy that’s not really working and may be causing side effects, you can get onto something else or add other drugs in.

We’ve also learned that the achievement of a normal level of BCMA is really as good as a complete remission. So, we all believe that complete remission or elimination of the markers, the end-all, the holy grail of myeloma. What we’re beginning to learn is that just achieving normalization, even among patients that don’t achieve complete remission, is a really good outcome.

So, for example, the last patient I just saw this morning in the clinic, a young woman with myeloma, her free light chain is still 10 times normal, but her BCMA level, thankfully, is right in the middle of normal. And so, I can reassure her that she’s going to do well. And we can also find that normalization signal about six to 10 times faster than you can a CR, even among patients who achieve CRs and normalize.

So, we believe that BCMA offers the opportunity to give a much quicker read on your response or your progression, can reassure you if you normalize, and also reassure you if you start with a lower level, you’re going to do quite well. 

Andrew Schorr:         

So, Dr. Berenson, how available is the testing for BCMA? 

Dr. Berenson:            

Well, the nice thing is it only requires about a tiny tip of your fork to run the tests. It’s stable at room temperature. So, it’s very convenient. It can be done with what’s called an ELISA-based test, which is really easy to do. It’s not yet commercially available, but we’re working hard on it. And I expect that to happen probably not this year but next year.

Andrew Schorr:         

Well, we’ve been talking so much about testing in myelomaso people know what version of myeloma they have. Genetic testing. Minimal residual disease or measurable residual disease testing. So, you see that this BCMA testing is going to become part of all that.

Dr. Berenson:            

Yes. And the other thing I should add in is there are a lot of patients who don’t have measurable or have barely measurable myeloma markers. And guess what? You can track them with BCMA now. And right now, those folks who require bone marrows every few months and PET scans. And with the development of BCMA you can track their disease really easily with just BCMA levels, a simple blood test.

Andrew Schorr:         

Okay. All right. We’ll stay tuned. We wish you luck with all that as you learn more about it. And hopefully as it pans out, BCMA may be coming to a clinic near you. But thank you for what you’re doing in research there in West Hollywood. Dr. James Berenson, thanks for being with us.

Dr. Berenson:            

Thank you. 

Andrew Schorr:         

Okay. Andrew Schorr here in Southern California also with another Californian, Dr. James Berenson, very devoted to you all as we all know that knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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