Multiple Myeloma Coverage from Every Angle

Detecting Resistance to Treatment in Multiple Myeloma With Liquid Biopsy

By: Joseph Fanelli
Posted: Monday, June 22, 2020

Monitoring the presence of multidrug resistance signatures in patients with multiple myeloma using liquid biopsy may improve future treatment strategies, according to findings presented in Blood Cancer Journal. This testing may inform targeted approaches against distinct cell clones with discrete phenotypes and could be considered during the design of treatment intervention, observed Sabna Rajeev Krishnan, PhD, of the University of Technology Sydney, and colleagues.

“Our test provides a [personalized] liquid biopsy with potential to address the unmet clinical need of monitoring [multidrug resistance] and treatment failure in myeloma,” the authors concluded.

The authors collected blood samples from 74 subjects, including healthy patients and those with multiple myeloma, from two hospitals in Australia. Three biomarkers were assessed: the multidrug resistant protein P-glycoprotein, the plasma-cell marker CD138, and phosphatidylserine. Of the patients with multiple myeloma, 30 achieved partial remission, 18 relapsed, 14 had de novo disease, and 12 reached complete remission. Additionally, the researchers assessed the complete signature of 4 markers in 11 patients: P-glycoprotein, CD138, phosphatidylserine, and CD34.

The investigators identified circulating large extracellular vesicles, specifically microparticles, which may be used to monitor disease burden, disease progression, and the development of multidrug resistance in myeloma cases. Elevated levels of P-glycoprotein and phosphatidylserine microparticles both correlated with disease progression and treatment unresponsiveness. Additionally, P-glycoprotein, phosphatidylserine, and CD34 were predominantly expressed in CD138 microparticles in instances of advanced disease. The authors observed a dual-positive population (CD138-CD34+P-gp+) that seemed to be linked to unresponsive disease.

Disclosure: The authors reported no conflicts of interest.

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