Grant title: Characterising the role of body composition and inflammation in multiple myeloma
Institution: University of Bristol
Grant awarded: September 2025
The support from World Cancer Research Fund is pivotal in advancing my research into how body composition and inflammation influence the development of multiple myeloma. By understanding how these factors contribute to myeloma risk, we aim to generate insights that could inform future prevention strategies.
This support is enabling me to develop as an independent researcher and future leader in the field of myeloma epidemiology and prevention, and I am deeply grateful for this opportunity – Dr Lucy Goudswaard
Background
Multiple myeloma is an incurable blood cancer, with around 188,000 people diagnosed globally in 2022. Before multiple myeloma develops, there is a condition called monoclonal gammopathy of unknown significance (MGUS), which is not cancerous. Around 5% of adults over the age of 50 have MGUS but only 1% will progress to multiple myeloma each year. To prevent or cure multiple myeloma, we need to understand why people get the disease.
There is evidence that obesity increases the risk of developing multiple myeloma. Obesity is also associated with higher levels of inflammation in the body. It is plausible that more inflammatory proteins circulating in the body may put blood cells under more stress and turn them to cancerous cells. Despite the known link between obesity and multiple myeloma risk, it is unclear whether obesity itself, or where the fat is stored (eg around the stomach), is more important in the development of multiple myeloma. It is also unclear which specific inflammatory proteins are involved in the development of this cancer.
Hypothesis and objectives
Hypotheses:
- Higher levels of inflammation are involved in the development of multiple myeloma.
- Obesity causes an increase in inflammation.
- Location of fat tissue may be more important than overall obesity in the development of multiple myeloma.
Objectives:
- Identify specific inflammatory proteins in the blood that are involved in the progression of MGUS to smouldering myeloma (the asymptomatic stage of multiple myeloma) and multiple myeloma.
- Determine how fat mass in different locations affects the risk of multiple myeloma.
- Determine whether inflammation is likely to mediate the relationship between obesity and multiple myeloma.
How it will be done
For this project we will measure 250 inflammatory proteins in existing blood samples from a myeloma screening programme in Iceland. We will also compare differences in inflammatory proteins across 45 patients who progress from MGUS to either smouldering myeloma or multiple myeloma, with 45 patients with stable MGUS who do not progress within 5 years.
We will also use data from individuals who have undergone magnetic resonance imaging (MRI) to investigate whether obesity or the location of fat is more important in the development of multiple myeloma. Specifically, we will use a method called Mendelian randomisation to explore whether the relationship between obesity and fat mass location with multiple myeloma risk is causal. Using a similar approach, we will also investigate whether inflammatory proteins are involved in the relationship between obesity and multiple myeloma risk.
Potential impact
This project could identify inflammatory proteins that play a role in the development of multiple myeloma and highlight those that could be targeted with drugs to help prevent or delay the disease. Additionally, by showing the most important component of obesity (whether it is the amount of fat or where the fat is located) relating to the development of multiple myeloma, it could help to recognise individuals at highest risk.