Integrative Multi-omics Analysis to Predict Monoclonal Gammopathies Clinical Evolution
Italy60 participantsStarted 2025-03-17
Plain-language summary
This prospective, multicenter, observational study aims to identify molecular and immunological markers associated with disease progression in patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). By integrating genomic, transcriptomic, immunophenotypic, and oral microbiome analyses, the study seeks to characterize the biological mechanisms underlying the transition to symptomatic multiple myeloma (MM). The study also includes in vitro modeling to investigate bone damage and immune dysfunction. Healthy volunteers (HV) undergoing joint replacement surgery for osteoarthritis will serve as controls. The ultimate goal is to improve early risk stratification and support future preventive strategies through a multi-omics approach. There is a pressing need for new strategies to identify high-risk individuals based on biological rather than purely clinical parameters. This study proposes an integrative, multi-omics approach to investigate the transition from MGUS/SMM to MM. By analyzing the immunome and oral microbiome alongside molecular profiling, the goal is to identify reliable biomarkers of progression. The resulting insights could be enable more accurate risk stratification and guide the design of future preventive clinical trials aimed at delaying or halting disease evolution.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Age \>18 years
* Male or female patients
* Histologically confirmed diagnosis of MGUS, SMM, or MM according to ESMO 2021 guidelines
* Willing and able to provide written informed consent
HEALTHY VOLUNTEERS (HV)
* Age \>60 years
* Diagnosis of osteoarthritis (OA)
* Scheduled for hospitalization for surgical treatment of OA (endoprosthesis or arthroplasty)
* Willing and able to provide written informed consent
Exclusion Criteria:
* Patients:
* Active current infection
* Autoimmune disease
* Women of childbearing potential unable to exclude pregnancy
* Use of high-dose corticosteroids within the past 7 days, potentially affecting immunome composition
Healthy Volunteers:
* Prior joint surgery or severe joint deformity
* Recent trauma, osteonecrosis, or OA caused by prior/current joint infection
* Metabolic disorders
* Previous or current cancer diagnosis
* Autoimmune diseases (e.g., rheumatoid arthritis)
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Bone marrow and peripheral blood immunophenotypic characterization
Timeframe: up to 24 months
2
Genomic and transcriptomic profiling of plasma cell