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IMS 2026 | CTCs and plasma MYD88 VAF as liquid biopsy markers in Waldenström macroglobulinemia
Tina Bagratuni, PhD, National and Kapodistrian University of Athens, Athens, Greece, discusses the use of circulating tumor cells (CTCs) and plasma MYD88 mutation variant allele fraction (VAF) as liquid biopsy markers in Waldenström’s macroglobulinemia. She highlights how both markers reflect disease burden across disease stages and can help distinguish responders from non-responders to ibrutinib, with greater reductions in CTCs and MYD88 VAF observed following treatment in responding patients. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
So, liquid biopsy has been shown that it’s a very promising tool in many hematological malignancies, as well as in Waldenstrom. There are a few studies that have supported this. So, our study shows that the CTCs can be detected in a large cohort of WM patients, and we can see that along the three disease stages, this is the IgM-GAS patient, the smoldering or asymptomatic patients, as well as the symptomatic patients, we can detect the CTCs...
So, liquid biopsy has been shown that it’s a very promising tool in many hematological malignancies, as well as in Waldenstrom. There are a few studies that have supported this. So, our study shows that the CTCs can be detected in a large cohort of WM patients, and we can see that along the three disease stages, this is the IgM-GAS patient, the smoldering or asymptomatic patients, as well as the symptomatic patients, we can detect the CTCs. And we do see significant differences in the CTC distribution among these patients. So this is very important because we can assess disease burden by using CTCs. In the same way, MYD88 VAF in the plasma cell-free DNA of these patients can show that MYD88, again, can be increased, along with IgM-GAS, from IgM-GAS to asymptomatic and symptomatic orders, and with significant differences in the MYD88 VAF as well. But I think one of the most important parts of this study shows that it can actually predict a kidney response as well. So we have used the same cohort of patients and we have screened them at the time of the diagnosis and post-therapy. And we do see that the CTCs are much higher in the non-responder patients. So this is something which can be used as a predictive tool. And again, the CTC dynamics, we do see that the CTCs are significantly decreased after therapy in the responders, but not in non-responder patients. So this again works with the MYD88 valve so we do see the similar trend. So I think that the liquid biopsy as determined by the CTCs and the MYD88 valve can be a very promising and easy tool for patients’ assessment in terms of their disease burden as well as the response to therapies.
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