This week's "Ask Dr. Durie" comes from a patient who is very, very interested in the Iceland project, the iStopMM project—Iceland screens, treats, or prevents multiple myeloma. And the question is, if we are studying myeloma at the earliest time point of the disease development at the point of MGUS, can we understand what is causing the myeloma and as the iStopMM name suggests, do we have the opportunity to prevent the original MGUS or even to prevent the progression to active myeloma?
And so, this is a very reasonable hope. But at this point, it is a hope rather than something which has been achieved. Active research is going on, and we're very excited that results are available related to the immune status, to the genetic status, and potential trigger factors in patients with early disease patients who have MGUS and smoldering myeloma.
Are there any immune defects that may be predisposing to the progression of the disease? Are there underlying molecular features that are predisposing factors? As we understand more about these things, then there will be the potential to understand what is causing these processes and also, to intervene with possible prevention of the original disease or progression to active disease.
We have one example of what is called the modifiable factor. It's known that MGUS and myeloma are actually linked to obesity. And so, this is what we call a modifiable factor. And in fact, in Iceland, we now have data that individuals who stay on the local high fish Icelandic diet are more likely to have the progression of the smoldering myeloma.
And so, we do feel that there is the potential to have interventions that may be helpful in this early disease phase. So the BOTTOM LINE is that understanding the cause or causes of myeloma and intervening to prevent the onset or progression are strong hopes for the future. But early data are encouraging. And so, we have some optimism that results will emerge that will be useful.