Is there any value to getting a bone marrow biopsy at the time of biochemical relapse in multiple myeloma before switching to a new line of therapy?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • University of Washington • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma

For many clinical trials, a screening bone marrow biopsy is necessary to get a new baseline. Do you do the same in real-world practice?

Answer from: Medical Oncologist at Community Practice

Not really. I'm sure there is a patient out there where FISH failed on all the prior bone marrow biopsies and finally, at this relapse, a t(11;14) is discovered which brings BCL2 inhibition into the treatment discussion. Physicians who are less familiar with myeloma will often repeat the bone marro...

Answer from: Medical Oncologist at Academic Institution

In certain circumstances, I obtain a bone marrow biopsy/aspiration. The first is if the existing FISH cytogenetic information was not available or inconclusive. Primarily, I want to know if t(11;14) is present which might open up the possibility of using venetoclax (as @Craig C. Hofmeister no...

Answer from: Medical Oncologist at Community Practice

This is a great question in a data-free zone. Biochemical relapse tends to be more indolent, with better overall survival compared to patients with clinical progression (Goldman-Mazur et al., PMID 35413102, Chakraborty et al., PMID 30663805). Patients with biochemical progression also demonstrate lo...

Comments

Medical Oncologist at Winship Cancer Institute of Emory University
t(11;14) is a fundamental genetic abnormality that...

Medical Oncologist at Mayo Clinic Rochester
Translocations and hyperdiploidy are well-establis...

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Agreed with all of you – these answers have ...

Medical Oncologist at CompHealth
Eventually. We should be able to look for cyclin ...

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