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In Multiple Myeloma (MM), a cancer of plasma cells, disease progression is determined by changes in biomarkers, such as serum concentration of the paraprotein secreted by plasma cells (M\u2010protein). Therefore, the time\u2010dependent behavior of M\u2010protein and the transition across lines of therapy (LoT), which may be a consequence of disease progression, should be accounted for in statistical models to predict relevant clinical outcomes. Furthermore, it is important to understand the contribution of the patterns of longitudinal biomarkers, upon each LoT initiation, to time\u2010to\u2010death or time\u2010to\u2010next\u2010LoT. Motivated by these challenges, we propose a Bayesian joint model for trajectories of multiple longitudinal biomarkers, such as M\u2010protein, and the competing risks of death and transition to the next LoT. Additionally, we explore two estimation approaches for our joint model: simultaneous estimation of all parameters (joint estimation) and sequential estimation of parameters using a corrected two\u2010stage strategy aiming to reduce computational time. Our proposed model and estimation methods are applied to a retrospective cohort study from a real\u2010world database of patients diagnosed with MM in the US from January 2015 to February 2022. We split the data into training and test sets in order to validate the joint model using both estimation approaches and make dynamic predictions of times until clinical events of interest, informed by longitudinally measured biomarkers and baseline variables available up to the time of prediction.<\/jats:p>","DOI":"10.1002\/sim.10322","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T05:43:46Z","timestamp":1737956626000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Bayesian Joint Model of Multiple Nonlinear Longitudinal and Competing Risks Outcomes for Dynamic Prediction in Multiple Myeloma: Joint Estimation and Corrected Two\u2010Stage Approaches"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3764-0397","authenticated-orcid":false,"given":"Danilo","family":"Alvares","sequence":"first","affiliation":[{"name":"MRC Biostatistics Unit University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica K.","family":"Barrett","sequence":"additional","affiliation":[{"name":"MRC Biostatistics Unit University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5685-1408","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Mercier","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spyros","family":"Roumpanis","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Yiu","sequence":"additional","affiliation":[{"name":"Roche Products Ltd  Welwyn Garden City UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Castro","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Schulze","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7209"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280218811837"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/24709360.2019.1693198"},{"issue":"245","key":"e_1_2_10_5_1","first-page":"1","article-title":"Joint Models for Dynamic Prediction in Localised Prostate Cancer: A Literature Review","volume":"22","author":"Parr H.","year":"2022","journal-title":"BMC Medical Research Methodology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-023-00852-4"},{"issue":"82","key":"e_1_2_10_7_1","first-page":"1","article-title":"Global Burden of Hematologic Malignancies and Evolution Patterns Over the Past 30\u2009Years","volume":"13","author":"Zhang N.","year":"2023","journal-title":"Blood Cancer Journal"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.46"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2008-0075"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.0807"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.201800274"},{"issue":"117","key":"e_1_2_10_12_1","first-page":"1","article-title":"Joint Modelling of Time\u2010To\u2010Event and Multivariate Longitudinal Outcomes: Recent Developments and Issues","volume":"16","author":"Hickey G. 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