K Number
K231601
Manufacturer
Date Cleared
2024-02-23

(267 days)

Product Code
Regulation Number
866.5550
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The FLC Kappa kit is intended for the quantification of Kappa free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in conjunction with other laboratory and clinical findings. For In Vitro Diagnostic Use only.

The FLC Lambda kit is intended for the quantification of Lambda free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in conjunction with other laboratory and clinical findings. For In Vitro Diagnostic Use only.

Device Description

The FLC Kappa and FLC Lambda test kits are intended for the quantification of free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure utilizing specific antibodies targeting anti-Lambda free light chains.

It is carried out in 8 successive steps:

  • Incubation of the previously diluted samples and calibrators, in the wells of the microplate, where specific free light chain antibodies are fixed.
  • Washing of the wells to remove elements that have not been fixed by the anti-free light chain antiserum.
  • Incubation with an anti- light chain antiserum (Kit specific) conjugated to peroxidase.
  • Washing of the wells to remove the excess of antiserum conjugated to peroxidase.
  • Incubation with peroxidase substrate.
  • Stopping of the enzymatic reaction with an acidic solution.
  • Reading of the optical density by absorbance spectrophotometry at 450 nm of the colored product.
  • Calculation of the free light chain concentration of the sample using a calibration curve obtained with calibrators that have been analyzed on the same microplate.
AI/ML Overview

The provided document is an FDA 510(k) clearance letter and associated summary for the Sebia FLC Kappa and FLC Lambda kits. These kits are in vitro diagnostic (IVD) devices used for quantifying free light chains in human serum. They are immunoassay-based tests, not AI/ML-driven devices.

Therefore, the requested information regarding acceptance criteria and study details for an AI/ML device cannot be extracted from this document. The concepts of "test set," "training set," "experts to establish ground truth," "adjudication methods," "MRMC studies," and "standalone performance" are relevant to AI/ML device evaluations, but they do not apply to the traditional IVD assay described here.

The document discusses analytical and clinical studies for the immunoassay, focusing on performance characteristics such as:

  • Clinical Study: Evaluates the concordance of FLC Kappa and FLC Lambda kit results with clinical assessment and other tests for monitoring Multiple Myeloma and AL Amyloidosis.
    • Sample size:
      • Multiple Myeloma: 551 follow-up samples from 235 unique subjects.
      • AL-amyloidosis: 190 follow-up samples from 87 unique subjects.
    • Data Provenance: Subjects had "expanded racial and ethnic diversity (Caucasian, African American, Hispanic, Asian)". No specific country of origin is mentioned, but the manufacturer is based in France and the submission is to the US FDA. The studies appear to be retrospective analyses of follow-up samples.
    • Ground Truth: Clinical assessment and other tests based on criteria from the IMWG (International Myeloma Working Group) for Multiple Myeloma and consensus guidelines (Comenzo et al., 2012; Palladini et al., 2012; Kumar et al., 2022 NCCN guidelines) for AL-Amyloidosis.
    • No mention of experts establishing ground truth or adjudication methods in the context of human readers for an AI system, as this is a laboratory assay.
    • No MRMC study, as this is not an image-based or AI-assisted diagnostic.
    • No separate "standalone" algorithm performance because the device itself is the diagnostic assay.
    • No specific training set or how its ground truth was established is mentioned, as this is a traditional laboratory assay, not a machine learning model.
  • Stability Studies: Determined shelf-life for the kits and controls.

In summary, this document describes a traditional immunoassay, not an AI/ML device. Thus, the requested AI/ML-specific information is not applicable and not present.

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Image /page/0/Picture/0 description: The image shows the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, with the letters "FDA" in a blue square. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

February 23, 2024

Sebia Karen Anderson Director of Regulatory Affairs and Ouality Assurance 1705 Corporate Drive Suite 400 Norcross, Georgia 30093

Re: K231601

Trade/Device Name: FLC Kappa, FLC Lambda Regulation Number: 21 CFR 866.5550 Regulation Name: Immunoglobulin (Light Chain Specific) Immunological Test System Regulatory Class: Class II Product Code: DFH, DEH Dated: January 12, 2024 Received: January 12, 2024

Dear Karen Anderson:

We have reviewed your section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (the Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database available at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Additional information about changes that may require a new premarket notification are provided in the FDA guidance documents entitled "Deciding When to Submit a 510(k) for a Change to an Existing Device"

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K231601 - Karen Anderson

(https://www.fda.gov/media/99812/download) and "Deciding When to Submit a 510(k) for a Software Change to an Existing Device" (https://www.fda.gov/media/99785/download).

Your device is also subject to, among other requirements, the Quality System (QS) regulation (21 CFR Part 820), which includes, but is not limited to, 21 CFR 820.30, Design controls; 21 CFR 820.90, Nonconforming product; and 21 CFR 820.100. Corrective and preventive action. Please note that regardless of whether a change requires premarket review. the OS regulation requires device manufacturers to review and approve changes to device design and production (21 CFR 820.30 and 21 CFR 820.70) and document changes and approvals in the device master record (21 CFR 820.181).

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR Part 803) for devices or postmarketing safety reporting (21 CFR Part 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safetyreporting-combination-products); good manufacturing practice requirements as set forth in the quality systems (OS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR Part 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR Parts 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Ying Mao -S

Ying Mao, Ph.D. Branch Chief Division of Immunology and Hematology Devices OHT7: Office of In Vitro Diagnostics Office of Product Evaluation and Quality Center for Devices and Radiological Health

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Indications for Use

510(k) Number (if known) K231601

Device Name FLC Kappa FLC Lambda

Indications for Use (Describe)

The FLC Kappa kit is intended for the quantification of Kappa free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in conjunction with other laboratory and clinical findings.

For In Vitro Diagnostic Use only.

The FLC Lambda kit is intended for the quantification of Lambda free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in conjunction with other laboratory and clinical findings.

For In Vitro Diagnostic Use only.

Type of Use (Select one or both, as applicable)X Prescription Use (Part 21 CFR 801 Subpart D)

Over-The-Counter Use (21 CFR 801 Subpart C)

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510K SUMMARY (Summary of Safety and Effectiveness)

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of 21 CFR 807.92.

Submitter NameSebia, Inc.
Address1705 Corporate Drive Suite 400Norcross, Georgia 30093, USA
ContactKaren Anderson, Dir of Regulatory, Sebia Inc.Phone: 1-800-835-6497Fax: 770-446-8511Email: karen.anderson@sebia-usa.comMatthew C Wagner, Scientific Affairs SpecialistPhone 1-800-835-6497, 3752Fax 770-446-8511Email: matthew.wagner@sebia-usa.com
Date PreparedFebruary 16, 2024
ManufacturingSebiaParc Technologique Léonard de VinciRue Léonard de Vinci,CP 8010 LISSES, 91008 EVRY CedexFRANCEPhone: (33) 1 69 89 80 80Fax: (33) 1 69 89 78 78
Product NameFLC KappaFLC Lambda
Common NameLight Chain immunological test system
Product Regulation No.21CFR sec. 866.5550 - Immunoglobulin (light chainspecific) immunological test system21 CFR sec. 862.1660- Quality Control Material(assayed and unassayed)
Product CodesDFH, Kappa antigen, antiserum, controlDEH, Lambda, antigen, antiserum, control
Device classification and PanelClassificationClass II, Immunology (82)
Establishment Registration No.8023024

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1. DEVICE DESCRIPTIONS

The FLC Kappa and FLC Lambda test kits are intended for the quantification of free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure utilizing specific antibodies targeting anti-Lambda free light chains.

It is carried out in 8 successive steps:

  • Incubation of the previously diluted samples and calibrators, in the wells of the microplate, i where specific free light chain antibodies are fixed.
  • Washing of the wells to remove elements that have not been fixed by the anti-free light chain i antiserum.
  • Incubation with an anti- light chain antiserum (Kit specific) conjugated to peroxidase. i
  • Washing of the wells to remove the excess of antiserum conjugated to peroxidase.
  • Incubation with peroxidase substrate. ।
  • Stopping of the enzymatic reaction with an acidic solution. i
  • Reading of the optical density by absorbance spectrophotometry at 450 nm of the colored i product.
  • । Calculation of the free light chain concentration of the sample using a calibration curve obtained with calibrators that have been analyzed on the same microplate.

The devices in this submission are not materially changed from cleared under K210623. The purpose for this submission is to:

  • add aids in the monitoring of Multiple Myeloma and Immunoglobulin Light-Chain (AL-) amyloidosis to the intended use,
  • extend shelf-life for FLC Kappa and FLC Lambda kits,
  • add additional data for shelf-life of FLC Controls Level 1 and Level 2.

2. REAGENTS

REAGENTS AND MATERIALS SUPPLIED IN THE FLC KAPPA AND FLC LAMBDA KITS

ITEMSPN 5102FLC Kappa KitPN 5103FLC Lambda Kit
Microplate Kappa 1 plate with 12segments, 8 wells eachMicroplate Kappa 1 plate with 12 segments, 8 wells eachMicroplate Lambda 1 plate with 12 segments, 8 wells each
Dilution buffer (ready to use)1 vial, 100 mL1 vial, 100 mL
Wash solution (stock solution)1 vial, 100 mL1 vial, 100 mL
Calibrators (ready to use)5 vials, 0.6 mL eachKappa Calibrators5 vials, 0.6 mL eachLambda Calibrators
PER antiserum (ready to use)1 vial, 12 mLAnti-Kappa - PERantiserum (ready to use)1 vial, 12 mLAnti-Lambda – PERantiserum (ready to use)
Substrate1 vial, 12 mLSubstrate Kappa (ready touse)1 vial, 12 mLSubstrate Lambda (readyto use)
Stop solution (ready to use)1 vial, 12 mL1 vial, 12 mL

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REAGENTS/SUPPLIES REQUIRED BUT NOT SUPPLIED IN THE KITS

SUPPLIESSEBIA PRODUCT NUMBER
Densitometer for microplate reading byabsorbance spectrophotometry at 450 nm.
NON COATED ELISA PLATES (10), SEBIA,microplates with scored wells in order tocomplete segments when the forecastednumber of samples per segment is fewer than8, and frameto store the segments that have not beenused.PN 5303
Absorbent paper for removal the excess ofwash solution from the wells of the microplate.
Multichannel pipette.
FLC CONTROL LEVEL 1PN 5112
FLC CONTROL LEVEL 2PN 5113

3. INDICATIONS FOR USE

FLC Kappa and FLC Lambda kits

The FLC Kappa kit is intended for the quantification of Kappa free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in coniunction with other laboratory and clinical findings. For In Vitro Diagnostic Use only.

The FLC Lambda kit is intended for the quantification of Lambda free light chains in human serum from adults with an Enzyme-Linked Immunosorbent Assay (ELISA) procedure. Measurement of free light chains aids in the diagnosis and monitoring of multiple myeloma and AL amyloidosis. It must be used in conjunction with other laboratory and clinical findings. For In Vitro Diagnostic Use only.

Special conditions for use statements: For prescription use only.

Warning: The result of the FLC Kappa and FLC Lambda in a given specimen determined with assays and/or instrument platforms from different manufacturers can vary due to differences in assay methods and reagent

specificity. The results reported by the laboratory to the physician must include the identity of the assay used. Values obtained with different assay methods cannot be used interchangeably. If, in the course of serially monitoring a patient, the assay method used for determining the FLC Kappa level is changed, additional sequential testing should be carried out. Prior to changing assays, the laboratory MUST confirm baseline values for patients being serially monitored.

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SUBSTANTIAL EQUIVALENCE INFORMATION

Predicate Device NamePredicate 510(k) numberRegulation No.
The Binding Site Freelite®Human Kappa Free Kit for use onthe Siemens BN™ IIK031016866.5550
The Binding Site Freelite®Human Lambda Free Kit for useon the Siemens BN™ IIK031016866.5550

4. COMPARISON WITH PREDICATE DEVICE

Kit Similarities (Table A).

Similarities

Table ACandidate DeviceFLC KappaFLC LambdaPredicateThe Binding Site Freelite® Human Kappa Freeand Freelite® Human Lambda Free kits for useon the Siemens BN™ II (K031016)
AnalyteKappa: Kappa FLCLambda: Lambda FLCSame
MeasurementQuantitativeSame

Kit Differences (Table B)

Differences
Table BCandidate DevicePredicate Device
Indications for UseThe FLC Kappa kit is intended for thequantification of Kappa free light chains inhuman serum from adults with anEnzyme-Linked Immunosorbent Assay(ELISA) procedure. Measurement of freelight chains aids in the diagnosis andmonitoring of multiple myeloma and ALamyloidosis. It must be used inconjunction with other laboratory andclinical findings.For In Vitro Diagnostic Use only.Special conditions for use statements:For prescription use only.Kappa: This kit is intended for thequantitation of kappa free light chains inserum and urine on the Siemens BN™ II.Measurement of free light chains aids in thediagnosis and monitoring of multiplemyeloma, lymphocytic neoplasms,Waldenstrom's macroglobulinemia, ALamyloidosis, light chain deposition diseaseand connective tissue diseases such assystemic lupus erythematosus inconjunction with other laboratory andclinical findings
The FLC Lambda kit is intended for thequantification of Lambda free light chainsin human serum from adults with anEnzyme-Linked Immunosorbent Assay(ELISA) procedure. Measurement of freelight chains aids in the diagnosis andmonitoring of multiple myeloma and ALamyloidosis. It must be used inconjunction with other laboratory andclinical findings.For In Vitro Diagnostic Use onlySpecial conditions for use statements:For prescription use only..Lambda: This kit is intended for thequantitation of lambda free light chains inserum and urine on the Siemens BN TM II.Measurement of free light chains aids inthe diagnosis and monitoring of multiplemyeloma, lymphocytic neoplasms,Waldenstrom's macroglobulinemia, ALamyloidosis, light chain depositiondisease and connective tissue diseasessuch as systemic lupus erythematosus inconjunction with other laboratory andclinical findings.
Specimen TypeHuman SerumHuman Serum, Human Urine
Detection MethodEnzyme-Linked ImmunosorbentAssay (ELISA)Nephelometric
Detection AntibodyKappa : Sandwich ELISA with polyclonalrabbit anti- human kappa free light chainscoated on the well of the microplate(capture antibody) and polyclonal rabbitanti-human kappa light chain conjugatedto horseradish peroxidase (HRP)(detection antibody)Kappa: Polyclonal sheep anti-humankappa antibody coated with latexparticles
Lambda: Sandwich ELISA with polyclonalrabbit anti-human lambda free light chaincoated on the well of the microplate(capture antibody) and polyclonal rabbitanti-human lambda light chainconjugated to horseradishperoxidase (HRP) (detection antibody)Lambda: Polyclonal sheep anti-humanLambda antibody coated with latexparticles
Analytical Measuring rangesKappaStandard dilution (1/1000)4.5 to 76.2 mg/L(dilution scheme 1/250 to 1/100 000)KappaStandard dilution (1/100)5.9 to 190 mg/L(dilution scheme 1/5 to 1/8000)
LambdaStandard dilution (1/1000)3.8 to 66.8 mg/L(dilution scheme 1/250 to 1/100 000)LambdaStandard dilution (1/100)5.0 to 160 mg/L(dilution scheme 1/5 to 1/8000)
Reference IntervalKappa: 6.4 to 17.4 mg/L.Lambda: 8.4 to 21.8 mg/L.Ratio: 0.46 to 1.51Kappa: 3.30 to 19.40 mg/LLambda: 5.71 to 26.30 mg/LRatio: 0.26-1.65

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Calibrators:

Similarities
ItemCandidatePredicate
Reference MaterialInternal Reference preparationSame
Differences
ItemCandidatePredicate
Number of levels5One

PERFORMANCE DATA 5.

Performance Data:

Extended indication for aids in the monitoring of multiple myeloma and AL amyloidosis. Extended shelf-life for FLC Kappa and FLC Lambda kits and additional data for shelf-life of FLC controls Level 1 and Level 2.

See submissions K210623 for previously documented analytical and clinical studies: Precision and Reproducibility Linearity/assay Limit of Blank (LOB) / Limit of Detection (LOD) / Limit of Quantitation (LOQ) Hook Effect (Antigen Excess) Traceability Analytical specificity: Biological and Drug Interferences In-use Stability Expected values/ Reference range Comparison studies: Quantitative and Qualitative comparison Clinical Study: Diagnosis of multiple myeloma and AL amyloidosis

a)Clinical Study

Monitoring of multiple myeloma and AL amyloidosis

Multiple myeloma

A total of 551 follow up samples from 235 unique subjects diagnosed with multiple myeloma and with expanded racial and ethnic diversity (Caucasian, African American, Hispanic, Asian) were included in the clinical study for FLC Kappa and FLC Lambda assays.

The concordance of the results obtained with FLC Kappa and FLC Lambda kits for monitoring the Multiple Myeloma with other tests and clinical assessment was evaluated based on criteria of the IMWG (International Myeloma Working Group).

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The obtained results are as follows:

Response basedClinical Assessment
on FLC AssaysGoodResponse*ModerateResponse**Stable Disease(SD)ProgressiveDisease (PD)Total
Good Response*7800179
ModerateResponse**08214096
Stable Disease(SD)02031012342
ProgressiveDisease (PD)0152834
Total7810332941551
Concordance100.0%79.6%94.2%68.3%90.4%
(n/N)(78/78)(82/103)(310/329)(28/41)(498/551)
(95% CI)(100.0%;100.0%)(71.8%;87.4%)(91.7%;96.7%)(54.0%;82.5%)(87.9%;92.8%)
  • Including subjects with Stringent Complete Response (sCR) and Complete Response (CR). ** Including subjects with Very Good Partial Response (VGPR) and Partial Response (PR).

The clinical sensitivity and specificity for the monitoring events regarding "Progression" and "Noprogression" based on criteria of the IMWG were evaluated with FLC Kappa and Lambda kits. The obtained results are as follows:

Response based onFLC AssaysClinical Assessment
ProgressionNo ProgressionTotal
Progression*28634
No Progression**13504517
Total41510551
  • Progression (PD- Progressive Disease): (≥ 25% increase of M-protein AND increase of M-protein ≥ 0.5 g/L) OR (≥ 25% increase of rd dFLC AND d dFLC increase > 100 mg/L). ** No Progression: all other cases.

AL-amyloidosis

A total of 190 follow up samples from 87 unique subjects diagnosed with AL-Amyloidosis and with expanded racial and ethnic diversity (Caucasian, African American, Hispanic) were included in the clinical study for FLC Kappa and FLC Lambda assays.

The concordance of the results obtained with FLC Kappa and FLC Lambda kits for monitoring the AL-Amyloidosis with other tests and clinical assessment was evaluated based on the consensus guideline for assessment of treatment response published by Comenzo et al., 2012, reiterated by Palladini et al., 2012 and updated in 2021 (Mode No. 1), and published by Kumar et al., 2022 as the National Comprehensive Cancer Network (NCCN) guidelines for AL-Amyloidosis (Mode No. 2).

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The obtained results are as follows:

Response based onFLC AssaysClinical Assessment (Evaluation mode No. 1)
CompleteResponse(CR)Very GoodPartialResponse(VGPR)PartialResponse(PR)Stable Disease/ No Response(SD/NR)ProgressiveDisease (PD)Total
Complete Response(CR)17220122
Very Good PartialResponse (VGPR)47414142108
Partial Response (PR)1291215
Stable Disease /No Response (SD/NR)02420228
Progressive Disease(PD)02001517
Total2282293522190
Concordance(n/N)(95% CI)77.3%(17/22)(59.8%;94.8%)90.2%(74/82)(83.8%;96.7%)31.0%(9/29)(14.2%;47.9%)57.1%(20/35)(40.7%; 73.5%)68.2%(15/22)(48.7%;87.6%)71.1%(135/190)(64.6%;77.5%)
Response based onFLC AssaysClinical Assessment (Evaluation mode No. 2)
CompleteResponse(CR)Very GoodPartialResponse(VGPR)PartialResponse(PR)Stable Disease/ No Response(SD/NR)ProgressiveDisease (PD)Total
Complete Response(CR)6820016
Very Good PartialResponse (VGPR)97314153114
Partial Response(PR)0391215
Stable Disease /No Response(SD/NR)02420228
Progressive Disease(PD)02001517
Total1588293622190
Concordance(n/N)(95% CI)40.0%(6/15)(15.2%;64.8%)83.0%(73/88)(75.1%;90.8%)31.0%(9/29)(14.2%;47.9%)55.6%(20/36)(39.3%; 71.8%)68.2%(15/22)(48.7%;87.6%)64.7%(123/190)(57.9%;71.5%)

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The clinical sensitivity and specificity for the monitoring events regarding "Progression" and "Noprogression" based on evaluation modes No. 1 and No. 2 were evaluated with FLC Kappa and Lambda kits. The obtained results are as follows:

Response based onFLC AssaysClinical Assessment (Evaluation mode No. 1)
ProgressionNo ProgressionTotal
Progression*15217
No Progression**7166173
Total22168190

Clinical Sensitivity: 68.2% (15/22) (95% Cl: 48.7% to 87.6%) Clinical Specificity: 98.8% (166/168) (95% Cl: 97.2% to 100.0%)

Response based onFLC AssaysClinical Assessment (Evaluation mode No. 2)
ProgressionNo ProgressionTotal
Progression*15217
No Progression**7166173
Total22168190

Clinical Sensitivity: 68.2% (15/22) (95% Cl: 48.7% to 87.6%) Clinical Specificity: 98.8% (166/168) (95% Cl: 97.2% to 100.0%)

* Progression (PD - Progressive Disease):

  • from CR: any detectable M-protein OR abnormal FLC ratio (involved FLC must be at least doubling from normal range),

  • from PR or VGPR: 50% increase in serum M-protein to > 5 g/L OR 50% increase in urine Mprotein to > 200 mg/day (a visible peak must be present); OR involved FLC increase greater than 50% to 100 mg/L at any time.

** No Progression: all other cases.

b) Stability

Shelf-life studies were conducted using the FLC Kappa and FLC Lambda kits and FLC controls Level 1 and Level 2. All results met stability acceptance criteria and product stability claims as listed in the tables below:

Stability of Kit (FLC Kappa and FLC Lambda)

KitShelf Life
FLC Kappa12 months at 2 - 8 °C
FLC Lambda12 months at 2 - 8 °C

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Stability of Controls (FLC Control Level 1 and FLC Control Level 2)

KitShelf Life
Claimed Shelf LifeReal time stability (time point available)Claimed Stability
FLC Control Level 14 years at 2 - 8 °C3 years at 2 - 8 °C2 years at 2 - 8 °C
FLC Control Level 23 years at 2 - 8 °C3 years at 2 - 8 °C2 years at 2 - 8 °C

6. CONCLUSION

The submitted information in this premarket notification is complete and supports a substantial equivalence decision.

§ 866.5550 Immunoglobulin (light chain specific) immunological test system.

(a)
Identification. An immunoglobulin (light chain specific) immunological test system is a device that consists of the reagents used to measure by immunochemical techniques both kappa and lambda types of light chain portions of immunoglobulin molecules in serum, other body fluids, and tissues. In some disease states, an excess of light chains are produced by the antibody-forming cells. These free light chains, unassociated with gamma globulin molecules, can be found in a patient's body fluids and tissues. Measurement of the various amounts of the different types of light chains aids in the diagnosis of multiple myeloma (cancer of antibody-forming cells), lymphocytic neoplasms (cancer of lymphoid tissue), Waldenstrom's macroglobulinemia (increased production of large immunoglobulins), and connective tissue diseases such as rheumatoid arthritis or systemic lupus erythematosus.(b)
Classification. Class II (performance standards).