PMID- 35356221 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220401 IS - 2234-943X (Print) IS - 2234-943X (Electronic) IS - 2234-943X (Linking) VI - 12 DP - 2022 TI - Risk Stratification Before and During Treatment in Newly Diagnosed Multiple Myeloma: From Clinical Trials to the Real-World Setting. PG - 830922 LID - 10.3389/fonc.2022.830922 [doi] LID - 830922 AB - Multiple Myeloma (MM) is a hematologic malignancy characterized by a wide clinical and biological heterogeneity leading to different patient outcomes. Various prognostic tools to stratify newly diagnosed (ND)MM patients into different risk groups have been proposed. At baseline, the standard-of-care prognostic score is the Revised International Staging System (R-ISS), which stratifies patients according to widely available serum markers (i.e., albumin, beta 2-microglobulin, lactate dehydrogenase) and high-risk cytogenetic abnormalities detected by fluorescence in situ hybridization. Though this score clearly identifies a low-risk and a high-risk population, the majority of patients are categorized as at "intermediate risk". Although new prognostic factors identified through molecular assays (e.g., gene expression profiling, next-generation sequencing) are now available and may improve risk stratification, the majority of them need specialized centers and bioinformatic expertise that may preclude their broad application in the real-world setting. In the last years, new tools to monitor response and measurable residual disease (MRD) with very high sensitivity after the start of treatment have been developed. MRD analyses both inside and outside the bone marrow have a strong prognostic impact, and the achievement of MRD negativity may counterbalance the high-risk behavior identified at baseline. All these techniques have been developed in clinical trials. However, their efficient application in real-world clinical practice and their potential role to guide treatment-decision making are still open issues. This mini review will cover currently known prognostic factors identified before and during first-line treatment, with a particular focus on their potential applications in real-world clinical practice. CI - Copyright (c) 2022 Bonello, Cani and D'Agostino. FAU - Bonello, Francesca AU - Bonello F AD - SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy. FAU - Cani, Lorenzo AU - Cani L AD - SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy. FAU - D'Agostino, Mattia AU - D'Agostino M AD - SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy. LA - eng PT - Journal Article PT - Review DEP - 20220309 PL - Switzerland TA - Front Oncol JT - Frontiers in oncology JID - 101568867 PMC - PMC8959380 OTO - NOTNLM OT - clinical trials OT - multiple myeloma OT - newly diagnosed OT - real world OT - risk stratification COIS- Author MD has received honoraria for lectures from and served on the advisory boards for GlaxoSmithKline and Sanofi. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/04/01 06:00 MHDA- 2022/04/01 06:01 PMCR- 2022/01/01 CRDT- 2022/03/31 05:28 PHST- 2021/12/07 00:00 [received] PHST- 2022/02/08 00:00 [accepted] PHST- 2022/03/31 05:28 [entrez] PHST- 2022/04/01 06:00 [pubmed] PHST- 2022/04/01 06:01 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fonc.2022.830922 [doi] PST - epublish SO - Front Oncol. 2022 Mar 9;12:830922. doi: 10.3389/fonc.2022.830922. eCollection 2022.