By: Monica Smith | December 19, 2025 | 6 min. read |
Summary
Sylvester Comprehensive Cancer Center’s innovative AI tool, CORAL, analyzes standard bone marrow biopsy slides to predict genetic subtypes and patient outcomes in multiple myeloma, bypassing the need for expensive genomic tests.
CORAL accurately identified major genetic subgroups and revealed hidden disease clusters, enabling more individualized and precise treatment decisions—even in more resource-limited settings within or outside the U.S.
The technology’s scalability means it could be applied to other cancers, opening the door to personalized, faster and widely accessible cancer care in the future.
Multiple myeloma treatment can often feel like navigating a city without a map. While doctors know the destination—longer survival and better quality of life—the roads to get there are complex, with crucial signs hidden deep in a patient’s DNA. Traditionally, uncovering these signs requires expensive genomic tests that demand time and resources many hospitals and outpatient clinics lack.
However, a new approach at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, powered by artificial intelligence (AI) is poised to change this landscape. This innovation, called CORAL, was recently showcased at the 2025 American Society of Hematology conference, held December 6-9.
During the conference, C. Ola Landgren, M.D., Ph.D., director of the Sylvester Myeloma Institute and professor and chief of the Miller School’s Division of Myeloma, was honored with the HealthTree Foundation’s Innovation Award for 2025, the organization’s most prestigious recognition. This award highlights the CORAL research that leverages AI to predict individual patient outcomes and guide treatment decisions, paving the way for the future of cancer care.
“Under Dr. Landgren’s leadership, Sylvester Myeloma Institute is developing novel strategies to better define multiple myeloma subtypes, which will help to facilitate more individualized treatment approaches and pave the way for precision medicine in the field of multiple myeloma. This will lead to optimized clinical outcomes for individual multiple myeloma patients,” said Jenny Ahlstrom, founder and CEO of HealthTree Foundation, an organization that provides education, community and research for blood cancer patients.
Ahlstrom noted that the most encouraging advancements in multiple myeloma care today include those that use genetics and technology to match patients with their best possible therapies.
“Using a clean and complete data set, AI has the potential to speed and expand research to create computational models that can personalize treatment recommendations, helping patients find their best possible therapies,” she added and explained that patients want quick answers, accessibility and individualized treatment.
“This is all possible with technology and innovative research partnerships,” she noted.
Turning Slides into Stories
CORAL works like a detective with a magnifying glass. Instead of waiting for genomic tests, CORAL studies the architecture of bone marrow biopsy slides. Using deep learning, the model reads these slides like pages in a book, spotting patterns in a patient’s cancer.
“Our goal was to remove barriers to precision care,” said Dr. Landgren. “The computational research team for CORAL, supervised by lead research scientist Arjun Raj Rajanna, has worked day and night the past two to three years and in close collaboration with me. By using AI to interpret standard biopsy images, we can deliver critical insights in real time without waiting for complex genomic tests.”
Dr. C. Ola Landgren was honored with the HealthTree Foundation’s Innovation Award at ASH 2025.
CORAL analyzed slides from more than 1,400 participants across three continents. It learned to recognize seven major genetic subgroups, including high-risk changes like del 17p and 1q gain, with accuracy rivaling traditional lab tests. Then, the model went further. It uncovered 12 distinct clusters, each with its own architecture and behavior, which revealed crucial information.
“The clusters tell us more than just what mutations are present,” Dr. Landgren explained. “They reveal how the disease behaves and responds to therapy, which is essential for tailoring treatment.”
Filling Genomic Testing Gaps
In Malaysia, where genomic testing wasn’t available, CORAL filled the gap. By combining image-based insights with clinical data, it predicted survival outcomes and identified five treatment-response clusters. These clusters act like traffic reports for doctors, signaling which routes, such as stem cell transplantation, lead to longer survival and which roads are fraught with risk.
“Technology is a great leveler. Patients in more resource-limited settings can now receive the same level of precision guidance as those in major cancer centers,” said Arjun Raj Rajanna, the lead research scientist who worked on CORAL with Dr. Landgren in Sylvester’s Myeloma Computational and Translational Research lab.
Looking Ahead
CORAL’s design is scalable, meaning it can grow with new data and expand to other cancers. Picture a future where every biopsy slide becomes a smart map, guiding doctors through the maze of cancer care with clarity and speed. By merging AI, pathology and clinical insight, Sylvester is helping rewrite the story of multiple myeloma.
“The scientific potential with this study is huge in that it allows detailed spatial characterization of tumor and host immune cells in individual samples. Also, because slide imaging is inexpensive and widely available, this approach has the potential to be used more broadly in community clinics and in developing countries,” Ahlstrom said. “HealthTree Foundation continues to be a strong collaborator and advocate for Dr. Landgren and the entire Sylvester Myeloma Institute at University of Miami.”
Tags: AI, artificial intelligence, ASH 2025, cancer research, Dr. C. Ola Landgren, multiple myeloma, myeloma, Sylvester Comprehensive Cancer Center, technology