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Better late than never?

Although additional validation studies are needed, the data suggest that knowledge of circulating miRNAs such as miR-155 may someday be used to predict which patients with MBL go on to develop overt CLL. Importantly, the investigators looked at several types of specimens, including CLL cells and plasma from patients with CLL. Plasma miR-155 was as effective a biomarker as miR-155 isolated from cells. Plasma is easier to work with for routine clinical biomarker screening than cellular material. Plasma has also been shown in a number of studies (reviewed in Cortez et al) to contain tiny microvesicles that package miRNA and other biomolecules. Although the investigators only analyzed a small number of samples, the work demonstrated that microvesicles isolated from the plasma of patients with CLL also contained miR-155. This raises important questions such as what the purpose of miR-155 in secreted microvesicles is, and can they act as hormones, as suggested. Having a plasma-based biomarker to predict which patients will respond to therapy is a Holy Grail of cancer therapeutics. Although future studies will require multicenter trials to evaluate the predictive value of miR-155, the results presented by Ferrajoli et al are very encouraging. Conflict-of-interest disclosure: The author declares no competing financial interests. n