ideasIdea
A watch-and-wait registry for blood precursor conditions found by chance
Blood tests increasingly find precursor conditions like MGUS and smouldering myeloma, but most never progress. A registry with clear rules would stop early treatment outside trials.
Smouldering myeloma treatment trials prompt calls for early therapy, yet most patients would never progress; iStopMM (Iceland) shows population MGUS screening is feasible. Propose a national precursor registry (MGUS, smouldering myeloma, monoclonal B-cell lymphocytosis, CHIP) with risk stratification, no treatment outside trials, and patient-reported outcomes.
Hypothesis
A stratified registry allows at least 80% of precursor patients to remain untreated over ten years while progression is detected before end-organ damage in at least 90% of those who progress.
Rationale
The harm to avoid is treatment creep as detection expands.
What would test it
Registry with pre-specified progression monitoring; compare outcomes with treated cohorts.
Maturity
early clinical
Who has to act
clinic
Cost to try
Medium ($1M to $50M)
Years to first evidence
6
Bottlenecks it attacks
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.
Pages like this
not linked directly; found by shared links- IdeaReduce the dose once the cancer responds: response-adapted de-escalation trials
- CompanyAdaptive Biotechnologies
- TermFlow cytometry (immunophenotyping)
- TermFixed-duration vs continuous therapy
- CollectionLeukemia & Lymphoma Society (LLS)
- TermCytogenetics and karyotype
- InstitutionGIMEMA
- TechnologyMultiparameter flow cytometry MRD