Serum protein fingerprinting by PEA immunoassay coupled with a pattern-recognition algorithms distinguishes MGUS and multiple myeloma

“Serum protein fingerprinting” study that aimed to look for stratifying markers and get some pathophsyiological insights in patients with Multiple Myeloma (MM) or the precursor lesion, Monoclonal grammopathy of undetermined significance (MGUS). MM remains essentially incurable even with the best combinational treatments. The authors suggest that better characterization of these tumors and the tumor microenvironment is needed for better staging of the disease, and to understand why current treatments ultimately fail. They had 4 sets of data: healthy controls, MGUS patients, MM patients and the same MM patients after treatment with autologous stem cell transplantation (ASCT). Biomarker data from the ONC I panel was obtained, and they then proceeded to undertake extremely complex statistical analysis using pattern recognition algorithms, essentially comparing every data set against every other data set. Using these algorithms, they were able to identify 2 or 3-marker “fingerprints” which they claim could distinguish between each group. Some of these proteins had interesting pathophysiological inferences: in particular, elevated levels of prosurvival and chemoprotective factors for myeloma cells were characteristic of MM patients, both pre and post-treatment.The authors speculate that suggests that once a patient develops MM, their tumor microenvironment is “permanently altered and primed for a relapse” and that this could explain why the disease remains incurable. [NOTE: on the surface this is an impressive study that uses Proseek to both identify protein markers that distinguish between different disease-related groups and to make significant pathophysiological conclusions. However, all of this was taken from just 16 MGUS & 16 MM patients and 7 healthy controls! The extrapolations of their conclusions seem to be highly disproportionate to the data set examined. Also, see the additional info in the “Comments” column regarding this journal].