Prognostic and predictive biomarker developments in multiple myeloma

Abstract

New approaches to stratify multiple myeloma patients based on prognosis and therapeutic decision-making, or prediction, are needed since patients are currently managed in a similar manner regardless of individual risk factors or disease characteristics. However, despite new and improved biomarkers for determining the prognosis of patients, there is currently insufficient information to utilise biomarkers to intensify, reduce or altogether change treatment, nor to target patient-specific biology in a so-called predictive manner. The ever-increasing number and complexity of drug classes to treat multiple myeloma have improved response rates and so clinically useful biomarkers will need to be relevant in the era of such novel therapies. Therefore, the field of multiple myeloma biomarker development is rapidly progressing, spurred on by new technologies and therapeutic approaches, and underpinned by a deeper understanding of tumour biology with individualised patient management the goal. In this review, we describe the main biomarker categories in multiple myeloma and relate these to diagnostic, prognostic and predictive applications.

Increased TOX expression associates with exhausted T cells in patients with multiple myeloma

“…Multiple myeloma is an aggressive, malignant, and incurable disease characterized by neoplastic plasma cell clone proliferation [ 1 ]. Poor prognoses of MM patients may be related to T cell immunodeficiency [ 2 ].…”

Serum Free Light-Chain Ratio at Diagnosis Is Associated with Early Renal Damage in Multiple Myeloma: A Case Series Real-World Study

“…β-2 microglobulin, a member of the β globulin family, is associated with human leukocyte antigen I on the cell surface, and is involved in antigen presentation, mucosal immunity, and tumor surveillance [ 40 ]. This globulin is used as a marker of tumor burden in lymphoid malignancies and MM, as increased serum levels and high LDH are related with poor survival and increased risk of disease progression [ 41 , 42 ]. Serum β-2 microglobulin and LDH levels have been incorporated in the International Staging System (ISS) for MM and in the Revised-ISS (R-ISS) together with serum albumin [ 42 , 43 , 44 ].…”

Functional transcriptomic landscape informs novel therapeutic strategies in multiple myeloma

“…We and others have reasoned that improving MM clinical outcomes with currently available therapeutics could be achieved through optimal therapeutic interventions using predictive biomarkers 18,19,33 . While diagnostic and prognostic biomarkers are integrated into clinical utilization in MM [4][5][6][7][8][9] , predictive biomarkers remain notoriously absent from clinical use 44 . Here, using functional transcriptomics as de ned by ex vivo drug screening as patient avatars (surrogates for clinical response) and paired molecular data, we identify critical MM biology and predictive molecular biomarkers.…”