Targeting the FOXM1/BUB1B signaling network in multiple myeloma: mechanistic insights and therapeutic potential

Multiple myeloma (MM) is a plasma cell cancer characterized by genomic instability and drug resistance. The FOXM1 transcription factor and the BUB1B kinase are pivotal drivers of this malignancy. FOXM1 promotes cell cycle progression and is upregulated by oncogenic pathways like mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT, correlating with aggressive disease. BUB1B ensures proper chromosome segregation, and its dysregulation fuels genomic instability. Critically, FOXM1 transcriptionally regulates BUB1B, forming an oncogenic axis that enhances proliferation, drug resistance, and survival. This FOXM1-BUB1B pathway is a promising therapeutic target, with inhibitors under preclinical investigation. Future research must validate its clinical relevance, explore combination therapies, and assess its potential as a biomarker to overcome challenges like toxicity and resistance.