iTIMM Study
Research type
Research Study
Full title
Image-guided Theranostics in Multiple Myeloma
IRAS ID
158185
Contact name
Christina Messiou
Contact email
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Summary of Research
For younger fitter patients with myeloma the standard treatment is induction chemotherapy followed by peripheral stem cell transplant. Outcomes are variable and although there are options for consolidating treatment we do not know which patients would benefit.
There is some evidence to suggest that residual disease on imaging after induction chemotherapy and after autograft confers a worse prognosis but the best time point for imaging is not known. There are broadly 2 imaging options, FDG PET/CT and whole body diffusion weighted MRI. We have a lot of experience in whole body diffusion weighted MRI and have successfully shown that it is reproducible, easily interpreted and have used it to measure how patients respond to treatment. Several studies have indicated that MRI is better at detecting disease than FDG PET/CT and we will confirm this when patients are first diagnosed by performing both FDG PET/CT and whole body diffusion weighted MRI. Patients will then be followed up with whole body diffusion weighted MRI after induction chemotherapy and 3 months post autograft. We will look at the amount of disease present on these scans and correlate this with outcomes. There are likely to be other factors which influence patient outcomes such as genetics and we will also look at these. Patients who undergo autograft have regular blood tests and marrow sampling and we will use these samples without compromising routine care. Some of the genetic tests performed on the bone marrow are not routine so we will obtain additional consent to do this. If we can predict which patients have poorer outcomes we would like to use this information in a future study to give such patients extra treatment.
Summary of Results
WB-MRI helped to detect a higher number of myeloma lesions and diffuse disease than FDG PET/CT.
WB-MRI helped identify at least one focal lesion in 83% (50 of 60) of participants, while FDG PET/CT helped identify at least one focal lesion in 60% (36 of 60) of participants.
■ Overall, in 82% (49 of 60) of participants, diffuse disease was detected with WB-MRI, compared to 17% (10 of 60) with FDG PET/CT.
■ All genetically high-risk tumours were characterized by diffuse disease infiltration at WB-MRI.
WB-MRI helped detect a higher number of myeloma lesions than FDG PET/CT, and diffuse disease detected at WB-MRI correlated with laboratory measures of disease burden and molecular markers of risk
REC name
London - Surrey Research Ethics Committee
REC reference
15/LO/0036
Date of REC Opinion
2 Feb 2015
REC opinion
Further Information Favourable Opinion