A study by the Institute of Cancer Research suggests that offering a combination of DNA profiling and RNA gene expression tests to people with multiple myeloma could help predict relapse within 18 months of treatment. The researchers say the approach detects hidden risks that standard tests may miss and could benefit thousands in the UK. There are about 33,000 people living with myeloma in the UK, with roughly 6,300 new cases each year. The disease is considered incurable, and while treatment can trigger remission, many patients relapse within 18 months. The MyelomaXI trial, which involved 135 patients given the same therapy plus detailed genetic testing, tracked outcomes for seven years and found relapse in 18.5% within 18 months of stem cell transplant. They concluded that combining the two tests would have predicted 84% of those early relapses.

DNA profiling searches for mutations in myeloma cells to gauge how aggressive the disease is. RNA-based expression testing measures how active specific genes are by analysing RNA. Both approaches are typically carried out using bone marrow samples. Prof Martin Kaiser, of the Institute of Cancer Research and Royal Marsden, notes the disease is highly complex and that some patients relapse early despite no obvious high-risk signs at diagnosis.

Prof Kristian Helin, chief executive of the Institute of Cancer Research, said the findings show early relapse affects thousands in the UK and that combining DNA and RNA testing offers a more accurate way to identify those at risk. This could enable earlier, personalised treatment decisions. He described precision diagnostics as a powerful way to improve patient care. Shelagh McKinlay of Myeloma UK said the work could help deliver a functional cure and underlined the study’s funding. From 2026, the Royal Marsden in London will become the first UK hospital to offer a gene expression profiling test to myeloma patients, helping clinicians understand cancer cell behaviour before planning treatment.