Multiple myeloma: is it time for biomarker-driven therapy?

Area of Science:

• Hematology
• Oncology
• Molecular Biology

Background:

• Multiple myeloma classification has advanced, incorporating molecular and genetic features.
• Despite advancements, significant heterogeneity in clinical outcomes persists within subtypes.
• Current treatment paradigms for multiple myeloma are generalized, leading to variable patient responses.

Purpose of the Study:

• To review the evolving role of biomarkers in multiple myeloma diagnosis and treatment.
• To highlight the need for personalized treatment strategies based on individual patient profiles.
• To discuss the potential of biomarkers in guiding risk-adapted therapy and monitoring treatment response.

Main Methods:

• Review of current literature on multiple myeloma biomarkers.
• Analysis of established and emerging biomarkers, including molecular, genetic, and imaging data.
• Discussion of the clinical utility of biomarkers in risk stratification and treatment decisions.

Main Results:

• Biomarkers like serum free light chain ratio and MRI focal lesions are integrated into new diagnostic criteria.
• Existing biomarkers help initiate treatment in asymptomatic individuals but lack evidence for risk-adapted therapy intensification or reduction.
• Minimal residual disease negativity shows promise as a biomarker for monitoring treatment effectiveness.

Conclusions:

• Personalized treatment approaches are essential for multiple myeloma, driven by expanding therapeutic options.
• Biomarker development is a key focus for improving patient outcomes in multiple myeloma.
• Further evidence is required to fully leverage biomarkers for tailoring treatment intensity in high-risk and low-risk multiple myeloma patients.