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Next-Generation Biomarkers in Multiple Myeloma: Advancing Diagnosis, Risk Stratification, and Precision Therapy

Marta Marques de Carvalho Lopes1, Laura do Amaral Xavier1, Silvia Cristina Verde Mendes Nolasco1

  • 1Postgraduate Program in Clinical and Toxicological Analysis, Department of Clinical and Toxicology Analysis, College of Pharmacy, Federal University of Minas Gerais, Prof. Moacir Gomes de Freitas Street-Pampulha, Belo Horizonte 31270-901, MG, Brazil.

Pharmaceuticals (Basel, Switzerland)
|February 27, 2026
PubMed
Summary

Advanced biomarkers like ctDNA methylome and multiomics show promise for improving multiple myeloma (MM) risk stratification and treatment. These tools can overcome current diagnostic limitations for better precision strategies in plasma cell disorders.

Keywords:
biomarkersmultiomicsmultiple myelomaprecision medicinetargeted therapy

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Area of Science:

  • Oncohematology
  • Biomarker Discovery
  • Genomics and Omics

Background:

  • Multiple myeloma (MM) is a plasma cell neoplasm with complex genetics.
  • Non-secretory MM, lacking monoclonal protein secretion, presents diagnostic challenges.
  • Current diagnostic and therapeutic models have limitations in precision medicine.

Purpose of the Study:

  • To conduct an integrative review of genomic, epigenomic, proteomic, metabolomic, and radiomic biomarkers for MM.
  • To evaluate the translational potential and clinical limitations of these biomarkers.
  • To identify gaps in current recommendations and explore future directions.

Main Methods:

  • Integrative narrative review of literature from 2018-2025.
  • Focus on multi-omics (genomic, epigenomic, proteomic, metabolomic) and radiomic biomarkers.
  • Analysis of biomarker categories including ctDNA methylome, single-cell multiomics, proteomics, ex vivo assays, and PET/CT radiomics.

Main Results:

  • ctDNA methylome, single-cell multiomics, surface antigen proteomics, ex vivo assays, and PET/CT radiomics show significant potential.
  • These biomarkers can enhance risk stratification, early progression detection, and therapy selection.
  • Identified novel therapeutic targets and applications beyond current guideline frameworks.

Conclusions:

  • Advanced biomarker platforms offer enhanced precision strategies for plasma cell disorders.
  • Integrating these biomarkers can overcome limitations in current diagnostic and therapeutic models.
  • Future research should focus on the clinical implementation of these promising biomarkers.