Assessment of Discordance Among Smoldering Multiple Myeloma Risk Models

Abstract

roll, the most common reasons were fear of increased ) or difficulty accessing care during the pandemic (30 [18.3%]) (Figure 2).Discussion | Despite a strong predisposition to participate in clinical research, nearly one-fifth of patients with cancer reported that they would be less likely to participate in a trial because of fears surrounding COVID-19. This observation was limited by reliance on a survey of volunteers with cancer, whose demographics and attitudes toward trial participation may not be representative of all patients with cancer, as well as by a 30.6% overall response rate. Nonetheless, the difference between those less vs more willing to participate in trials in light of the pandemic was stark, was consistently observed across evaluable demographic/socioeconomic patient groups, and extended even to those who previously agreed to participate and who had the most imminent opportunity to enroll.The present findings suggest that as long as high rates of COVID-19 cases exist, patients with cancer will be less likely to consider trial participation even when sites return to prepandemic status.

Heterogeneity of enrolment criteria for ongoing smouldering myeloma trials

“…It must be emphasised, that there is poor concordance between the different criteria used to evaluate risk of progression in SMM, with a study demonstrating that the overall rate of agreement between three models of SMM risk assessment (Old Mayo, IMWG 20/2/20 and PETHEMA) only being 16.6% 9 . Thus, lessons learnt from studies using one of these criteria, may not be generalisable to lessons learnt from studies using other criteria.…”

2021 European Myeloma Network review and consensus statement on smoldering multiple myeloma: how to distinguish (and manage) Dr. Jekyll and Mr. Hyde

“…Prediction of progression to overt MM of SMM should be based on routine and universally applicable tests, considering, however, that proposed models may show significant discordances in identifying “true” high-risk SMM. 101 All the clinical prognostic scores reported above, particularly the updated 2/20/20 model (endorsed by the IMWG and including variables that reflect both disease burden and biological features of SMM that can be measured by most centers), represent important tools that physicians must routinely use (whatever they select) for risk stratification, to reasonably predict the outcome of different patients with SMM, because their management should be riskadapted. Combination with appropriate imaging investigation is also recommended.…”

Smoldering multiple myeloma: evolving diagnostic criteria and treatment strategies

“…Although the PETHEMA and Mayo Clinic 2018 mod els are used in clin i cal tri als and prac tice, the clas si fi ca tion of "highrisk" SMM is sig nifi cantly dis cor dant between the mod els. 34 Therefore, to fur ther opti mize risk strat i fi ca tion, the IMWG recently devel oped a risk strat i fi ca tion model incor po rat ing highrisk cyto ge netic mark ers (t(4;14), t(14;16), gain 1q, mono somy 13/dele tion 13q) and more refined cri te ria for risk fac tors included in the Mayo Clinic 2018 model. 33 Using the IMWG 2020 model, inter me di ate and high risk patients with SMM had a 2year risk of pro gres sion to mye loma or amy loid osis of 51% and 73%, respec tively.…”