Why is it important?
The iStopMM trial is a prospective study that aims to evaluate the impact of actively screening for MGUS, and if the knowledge of MGUS condition could lead to an improvement in overall survival for these patients
All Icelanders over the age of 40 were invited to participate in the iStopMM study; which commenced in September 2016. Approximately 80,000 individuals consented to take part to this study, for a total participation rate of about 50% of the Icelandic population over the age of 40. The process involved the collection of a blood sample; this was used to identify the presence of monoclonal proteins produced by the clonal expansion of plasma cells.
The Binding Site is a proud collaborator of this study, and almost 80,000 samples were sent to our laboratories in Birmingham, UK, where they were screened for a monoclonal protein using serological methods.1,a,b,
If a person was identified as having MGUS as part of the iStopMM study, they were considered eligible for a randomized trial of follow-up strategies with 3 longitudinal arms. The testing identified 3,487 MGUS patients and these were randomized into the three arms in the study, evenly distributed with regard to patient characteristics such as age, gender and mean monoclonal protein concentration.6
The data collected will indicate the best follow-up strategy for patients identified as having an MGUS, also addressing the psychological burden from the knowledge of a pre-cancerous condition in the patients.
The study will also evaluate the potential benefits of close monitoring for individuals with MGUS identified by screening, to help identify those at highest risk of progression and allow for early intervention, if necessary, to improve the treatment outcomes.7,d,e
Overall, the iStopMM study provides important insights into the prevalence and natural history of MGUS, as well as the potential benefits of a population-based screening and early intervention. However, further research is needed to determine the optimal screening strategies and interventions for individuals with MGUS.1,f,g