Normalization of serum B‐cell maturation antigen levels predicts overall survival among multiple myeloma patients starting treatment

Abstract

Serum B-cell maturation antigen (sBCMA) is a novel biomarker for B-cell malignancies. A normal reference range (<82Á59 ng/ml) has been recently established but the impact of achieving normal levels to outcomes for patients receiving treatment for B-cell malignancies has not been studied. We first found that among multiple myeloma (MM) patients starting a new treatment, those who begin treatment within normal sBCMA limits (<82Á59 ng/ml) have improved progression-free survival (PFS; P = 0Á0398) and overall survival (OS; P = 0Á0217) than those who do not. Furthermore, among patients who begin treatment with elevated (≥82Á59 ng/ml) sBCMA levels, we assessed the relationship of a decrease in sBCMA to the normal range to OS and found that those who normalize sBCMA demonstrated improved OS (P = 0Á0078). Normalizing patients also experienced a markedly improved overall response rate (P < 0Á0001). Moreover, all patients who achieved complete remission (CR) showed normalization of sBCMA, and time to normalization (median 0Á9 months) was faster than time to CR (5Á0 months; P = 0Á0036) for these patients. These results suggest that normalization of sBCMA may be an accurate predictor of OS for MM patients during treatment and predict for a higher likelihood of response.

Use of serum B‐cell maturation antigen levels to predict outcomes for myeloma patients treated with ruxolitinib, lenalidomide and methylprednisolone

“…This study reinforces the value of sBCMA as a prognostic biomarker for PFS among MM patients 14 . Specifically, those with elevated sBCMA consistently show shorter PFS regardless of the type of treatment that the patient is receiving 14,18 .…”

“…We have recently shown that changes in sBCMA levels predict PFS regardless of the drugs which the patient is receiving. 14 Having a serum marker, that is, unrelated to the monoclonal antibody produced by the malignant clone provides another way to assess changes in clinical status and help avoid the limitations of using only antibody-related biomarkers to assess changes in the clinical status of MM patients. This new biomarker will also provide the treating healthcare professional with more reassurance that the changes in clinical status as determined with this marker are truly reflective of the patient's current clinical status.…”

Advances and perspective of the immunotherapy for relapsed/refractory multiple myeloma (interview)

“…В результате действия γсекретаз мембранная форма BCMA расщепляется, что приводит к образованию растворимой формы BCMA (sBCMA) [25]. Определение данной молекулы в сыворотке крови, как оказалось, имеет важное зна чение, в частности для прогностической оценки эф фективности BCMAнаправленной терапии [26].…”

Mechanisms of Action of the New Antibodies in Use in Multiple Myeloma

“…Patients with levels above the median had shorter progression free survival and overall survival ( 140 ). Normalization of sBCMA during any treatment was predictor of increased overall response rate, overall survival ( 141 ), and achievement of complete response ( 141 ). Currently, sBCMA ( 139 , 140 ) and sTACI are investigated as novel biomarker of disease activity in B-cell disorders with prognostic value ( 142 ), with two main advantages: independence from renal kidney and shorter half-life (24–36 h) than monoclonal components IgG (21 days) and IgA (7 days), or free light chains ( 140 , 141 ).…”