Detectable ctDNA predicts inferior survival in multiple myeloma: updated meta-analysis
The study reports a systematic review and meta-analysis of 14 cohorts comprising 948 patients with multiple myeloma to assess the prognostic value of circulating tumor DNA. Investigators found that detectable ctDNA was associated with a significantly higher risk of disease progression (HR 3.21) and reduced overall survival (HR 3.97). Subgroup analyses demonstrated consistent prognostic utility across detection methods and treatment settings, although associations lost significance in newly diagnosed patients and Asian cohorts. The findings position ctDNA as a promising non-invasive biomarker for risk stratification, though laboratory implementation will require further validation in specific disease stages and populations.
The original study
Unveiling the Prognostic Power of Circulating Tumor DNA in Multiple Myeloma: A Systematic Review and Updated Meta-Analysis.
- Authors
- Ying W, Fan L, Li R, Qu X
- Journal
- Cancer medicine
- Type
- Journal Article, Systematic Review, Meta-Analysis, Review
- PMID
- 42802646
Original abstract
Circulating tumor DNA (ctDNA) serves as a non-invasive liquid biopsy technique, offering potential utility in the prognostic evaluation of multiple myeloma (MM). In this study, we performed a systematic review and updated meta-analysis to analyze the association between ctDNA and the prognosis of patients diagnosed with MM. A comprehensive literature search was performed across PubMed, Embase, Web of Science, and the Cochrane Library to retrieve relevant literature published up to May 29, 2025, assessing the impact of ctDNA on survival outcomes in patients with MM. The survival outcomes included overall survival (OS), progression-free survival (PFS), and time to progression (TTP). A total of 948 MM patients from 14 studies were included in the analysis. Patients with detectable ctDNA exhibited a significantly increased risk of aggressive disease progression (hazard ratio [HR], 3.21; 95% confidence interval [CI], 1.98-5.18) and reduced OS (HR, 3.97; 95% CI, 2.24-7.04). Subgroup analyses consistently indicated that ctDNA positivity was associated with accelerated disease progression, irrespective of race, disease status, treatment, or ctDNA detection method. In subgroups defined by relapsed or refractory MM (RRMM) and Oceanian or Caucasian race, ctDNA positivity was significantly correlated with poorer OS. However, the associations were not significant in newly diagnosed MM (NDMM) or among Asian patients. Therefore, we conclude that ctDNA is a potential predictor of inferior survival outcomes in MM patients.