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What Is a Mass Spectrometry Test?

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Published on February 27, 2020

Key Takeaways

  • A mass spectrometry test is a more precise way to look for serum protein then SPEP (serum protein electrophoresis) tests. With it, you can get down to 10-4, 10-5 in terms of sensitivity.
  • Mass spectrometry tests also allow pathologists to more clearly discriminate between daratumumab and the original M-protein that’s found in blood.
  • Mass spectrometry tests will not replace other testing like bone marrow biopsies, but they could replace SPEPs in the future.

What is a mass spectrometry test, and how could it benefit me in my multiple myeloma care? Watch as expert Dr. Sagar Lonial, from the Winship Cancer Institute, explains the differences between this test and standard tests like the serum protein electrophoresis (SPEP) test.

This town hall meeting is sponsored by Janssen Biotech, Inc. and Karyopharm Therapeutics with additional support to our partner, Myeloma Crowd (MCR), from Takeda Oncology and Foundation Medicine. These organizations have no editorial control, and Patient Power is solely responsible for the content. It is produced by Patient Power in partnership with The University of Texas MD Anderson Cancer Center.

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Transcript | What Is a Mass Spectrometry Test?

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.

Jack Aiello:               

Dr. Lonial, I hear something about mass spectrometry tests that are going on, predominately at Mayo and maybe that’s moving forward. Is it? What are the benefits of mass spec when that becomes available?

Dr. Lonial:                

Yeah. I think mass spec is just a more sensitive way to look for the protein. The nice parts about mass spec really are more on the pathology side in the sense that it reduces the staff that you need in the lab to be able to run all these SPEPs. So, currently, at least in our lab, we have three or four people that run SPEPs constantly because they’re always coming in. You can reduce that to one by doing mass spec.

Mass spec also gives you more sensitivity than an SPEP. So, you may be able to get down to 10-4, 10-5 in terms of sensitivity. And it allows you to discriminate between daratumumab (Darzalex) in the blood and the original M-protein that’s in the blood, which right now is a little bit more challenging with routine serum protein electrophoresis.

It can be done in experienced labs. Even some patients whose antibody may look like daratumumab, it becomes a little bit more challenging. Mass spec can very clearly delineate those. It is a test that I think is coming. It’s not going to replace a bone marrow. It will probably replace SPEPs. We’re probably going to be up with them the next month or so.

Jack Aiello:               

So, you bring up a really good point with respect to daratumamab or Darzalex in that it might affect a normal SPEP reading for your IgG number or your M spike a little bit. So, what has to be done in that case? Is it the hemapathologist that has to read things differently? Is it different test that has to be done? How does that work? 

Dr. Lonial:                

So, there is a test you can do. It’s called the daratumumab test, which basically pulls daratumumab out and then runs the SPEP and allows you to look at is the original protein there or not. In most patients’ cases, our immunology lab can differentiate daratumumab and they’ll say the original protein is gone but there’s a small daratumumab peak there that’s about 0.2 or 0.3. That’s usually enough for me. If they can clearly distinguish it, then I’m okay with it. But you can do this anti-daratumumab test if you want to try and eliminate it.

Jack Aiello:               

Does MD Anderson, Dr. Patel, use this or, Dr. Lin, use this daratumumab test? 

Dr. Lin:                     

I’m not aware of it.

Dr. Patel:                  

We don’t usually use it. I can ask for it if there’s a specific question that I need that information for. Then we can get it done, but it’s not something we routinely do, because a lot of my patients are on daratumumab. It already takes us a little bit of time to get the SPEPs back to add another test to it, because it does take extra people to do this. We ask for it specifically if there’s a question that it would affect.

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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