Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies

• Published in: Blood Cancer Journal
• Main Authors: Sæmundur Rögnvaldsson, Thorvardur Jon Love, Sigrun Thorsteinsdottir, Elín Ruth Reed, Jón Þórir Óskarsson, Íris Pétursdóttir, Guðrún Ásta Sigurðardóttir, Brynjar Viðarsson, Páll Torfi Önundarson, Bjarni A. Agnarsson, Margrét Sigurðardóttir, Ingunn Þorsteinsdóttir, Ísleifur Ólafsson, Ásdís Rósa Þórðardóttir, Elías Eyþórsson, Ásbjörn Jónsson, Andri S. Björnsson, Gunnar Þór Gunnarsson, Runólfur Pálsson, Ólafur Skúli Indriðason, Gauti Kjartan Gíslason, Andri Ólafsson, Guðlaug Katrín Hákonardóttir, Manje Brinkhuis, Sara Lovísa Halldórsdóttir, Tinna Laufey Ásgeirsdóttir, Hlíf Steingrímsdóttir, Ragnar Danielsen, Inga Dröfn Wessman, Petros Kampanis, Malin Hultcrantz, Brian G. M. Durie, Stephen Harding, Ola Landgren, Sigurður Yngvi Kristinsson
• Format: Article in Journal/Newspaper
• Language: English
• Published: Nature Publishing Group 2021
• Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282; Iceland
• Online Access: https://doi.org/10.1038/s41408-021-00480-w; https://doaj.org/article/7fd4f709b36d424e99ae0fd9685cdaff

Abstract Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.