Abstract
Immune checkpoint signaling plays an important role in immunosuppression in multiple myeloma (MM). Blood levels of soluble programmed death-ligand 1 (sPD-L1), a checkpoint-relevant protein, might predict treatment response and survival outcomes in MM patients. We used an enzyme-linked immunosorbent assay to measure serum sPD-L1 levels in 81 newly diagnosed MM patients. We found that myeloma patients had higher sPD-L1 concentrations than healthy controls. The best sPD-L1 cutoff value for predicting disease progression risk was 2.783 ng/mL. The overall response rate to treatment was higher in low sPD-L1 patients than in high sPD-L1 patients. The 3-year progression free survival (PFS) and overall survival (OS) rates for all patients were 16% and 64%, respectively. Multivariate survival analysis including Eastern Cooperative Oncology Group performance status score, treatment response, and sPD-L1 level showed that a less than partial treatment response (PR) and higher sPD-L1 levels (>2.783 ng/ml) were independent prognostic factors for shorter PFS; neither factor was predictive of OS. The serum sPD-L1 level is a valuable biomarker for predicting treatment response and an independent prognostic factor for PFS. PD-1/ PD-L1 blockade may be a promising novel immune-based therapeutic strategy in MM.
Highlights
Multiple myeloma (MM) is a fatal plasma cell malignancy that mainly affects older individuals [1]
There was no significant correlation between soluble programmed death-ligand 1 (sPD-L1) level and gender, age, International staging system (ISS) stage, lactate dehydrogenase (LDH) level, renal function, or treatment regimens (p > 0.05)
We investigated serum levels of sPD-L1 in a large series of MM patients to identify any correlations with patient characteristics and survival outcomes
Summary
Multiple myeloma (MM) is a fatal plasma cell malignancy that mainly affects older individuals [1]. Achieving a complete response to treatment is crucial for long-term control of MM [2,3,4]. The advent of novel proteasome inhibitors and immunomodulatory drugs has improved response rates and progression-free survival (PFS) [5]. MM remains incurable, and most patients eventually relapse and succumb to the disease. Drug resistance is a major challenge in treating relapses of MM. Alternative treatment methods that target novel mechanisms to overcome drug resistance are an area of active research. Biomarkers that can predict patients’ drug response would be helpful in choosing optimal treatment strategies for MM
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