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Circulating tumor DNA correlates with increased risk of aggressive disease progression and reduced overall survivalCirculating tumor DNA levels predict survival in multiple myeloma patients

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Key Takeaway
Note that ctDNA is associated with higher risk of progression and reduced survival in multiple myeloma patients.

This meta-analysis evaluated the prognostic value of circulating tumor DNA (ctDNA) in patients diagnosed with multiple myeloma. The analysis included a total sample size of 948 patients to determine the association between ctDNA and clinical outcomes, including overall survival (OS) and progression-free survival (PFS).

The meta-analysis found that ctDNA was associated with an increased risk of aggressive disease progression (HR 3.21; 95% CI, 1.98-5.18). Furthermore, ctDNA was associated with reduced overall survival (HR 3.97; 95% CI, 2.24-7.04). Subgroup analyses indicated that ctDNA correlated with poorer OS in patients with relapsed or refractory multiple myeloma, as well as in patients of Oceanian or Caucasian race.

While the results suggest ctDNA is a potential predictor of inferior survival outcomes, the study is an observational meta-analysis and does not establish a causal link. Clinical application of ctDNA as a predictive tool requires further validation. The authors did not report specific limitations or safety data for the markers analyzed.

How this fits prior evidence

This finding addresses a gap in identifying prognostic biomarkers for multiple myeloma. While previous evidence identified D-dimer as a potential risk marker in high-risk multiple myeloma with a pooled SMD of 1.60, this meta-analysis adds ctDNA as another potential predictor of inferior survival outcomes. The results regarding ctDNA and progression risk (HR 3.21) and reduced survival (HR 3.97) provide additional data on prognostic indicators in the disease.

Living with multiple myeloma means facing a complex and often aggressive form of cancer. For patients and their families, knowing how the disease might progress is vital for making informed decisions about care. New data suggests that looking at circulating tumor DNA (ctDNA) can provide a clearer picture of how the disease might behave.

Researchers analyzed data from 948 patients to see if these DNA fragments could predict outcomes. They found that higher levels of ctDNA were linked to a much higher risk of aggressive disease progression. Specifically, patients with these markers showed a significant decrease in overall survival. This link was also seen in specific groups, including patients whose cancer had already relapsed or become harder to treat.

While this finding shows that ctDNA is a potential predictor of survival, it is important to remember that this was not a clinical trial. It shows an association between the DNA markers and the outlook for the disease. Because the data is still being interpreted, talk to your doctor about how these markers might apply to your specific situation.

What this means for you:
Higher levels of circulating tumor DNA are linked to faster disease progression in multiple myeloma patients.

Common questions

What is circulating tumor DNA and how does it affect my diagnosis?

Circulating tumor DNA (ctDNA) refers to fragments of DNA from cancer cells that enter the bloodstream. In this study of 948 patients, higher levels of this DNA were linked to a higher risk of aggressive disease progression. It serves as a potential predictor of how the disease might behave over time.

Does this finding apply to everyone with multiple myeloma?

The data showed that ctDNA was linked to poorer survival outcomes across several groups. This included patients with relapsed or refractory multiple myeloma, as well as patients of Oceanian or Caucasian race. These results suggest the marker can identify specific risks for different groups of patients.

Is this a new treatment for my cancer?

No, this is not a new treatment. The study found an association between ctDNA and survival outcomes. It is a way to measure the disease's progression rather than a medicine. You should speak with your doctor to understand what these findings mean for your specific treatment plan.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View 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.
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