Enhancing risk stratification and treatment decision in multiple myeloma with SKY92 gene expression profiling in real-world data Journal Article


Authors: Biran, N.; Dhakal, B.; Niesvizky, R.; Lentzsch, S.; Bhutani, D.; McKay, J. T.; Vesole, D. H.; Nooka, A.; Paul, B.; Hari, P. N.; D'Ambrosi, S.; Kuiper, R.; van Vliet, M.; Siegel, D.; Usmani, S. Z.; van Rhee, F.
Article Title: Enhancing risk stratification and treatment decision in multiple myeloma with SKY92 gene expression profiling in real-world data
Abstract: Over the years, numerous prognostic markers for multiple myeloma (MM) risk classification have been identified; however, their variability can lead to inconsistent clinical interpretations. Gene expression profiling (GEP) signatures, such as SKY92, offer a more accurate method for patient stratification. The PRospective Observational Multiple Myeloma Impact Study (NCT02911571) aimed to validate SKY92's prognostic performance using real-world data and assess its impact on risk classification and treatment decisions compared to conventional markers. In a study of 251 newly diagnosed MM patients, physicians completed questionnaires to capture risk classification, hypothetical treatment plans and their confidence in those plans before and after unblinding SKY92 results. Poor concordance was observed between initial clinical risk assessment (iCRA) and SKY92 results (high risk: 51% iCRA vs. 28% SKY92, Cohen's κ = 0.21). SKY92 showed superior performance in identifying high-risk patients, leading to better predictions of progression-free survival and overall survival (p ≤ 0.0001) than traditional risk markers. Unblinding SKY92 results led to hypothetical treatment revisions for 50% of patients (p < 0.001) and increased physicians' confidence in treatment decisions for 40% of cases. These findings support SKY92's prognostic value in identifying high-risk MM patients, outperforming traditional risk markers and demonstrating the potential added value of its integration into clinical practice for more personalized risk assessment. © 2025 British Society for Haematology and John Wiley & Sons Ltd.
Keywords: adult; aged; aged, 80 and over; middle aged; major clinical study; overall survival; genetics; clinical trial; mortality; prospective study; prospective studies; clinical practice; progression free survival; multiple myeloma; gene expression profiling; cytogenetics; tumor marker; risk assessment; multicenter study; diagnosis; risk stratification; clinical decision making; observational study; fluorescence activated cell sorting; therapy; prognostic; procedures; treatment decision; density gradient centrifugation; clinical decision-making; very elderly; humans; prognosis; human; male; female; article; biomarkers, tumor; ecog performance status; molecular hematology; sky92 gene expression profiling
Journal Title: British Journal of Haematology
Volume: 206
Issue: 6
ISSN: 0007-1048
Publisher: John Wiley & Sons  
Date Published: 2025-01-01
Start Page: 1642
End Page: 1653
Language: English
DOI: 10.1111/bjh.20050
PUBMED: 40231946
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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