Researchers have discovered why multiple myeloma, a difficult to cure cancer of the bone marrow, frequently recurs after an initially effective treatment that can keep the disease at bay for up to several years.
Working in collaboration with colleagues at Princess Margaret Cancer Centre in Toronto, researchers from Mayo Clinic in Arizona and the Translational Genomics Research Institute (TGen) in Phoenix were part of the team that conducted the study published in the Sept. 9 issue of “Cancer Cell.”
The research team initially analyzed 7,500 genes in multiple myeloma cells to identify genes which when suppressed made cancer cells resistant to a common class of drugs called proteasome inhibitors such as bortezomib or carfilzomib. Then, the team studied bone marrow biopsies from patients to further understand their results. The process identified two genes (IRE1 and XBP1) that control response to the proteasome inhibitor and the mechanism underlying the drug resistance that is the barrier to cure.
Risk stratification and therapeutic approach for effective treatment of multiple myeloma
As mentioned above, effective treatment can keep multiple myeloma at bay for several years. However, because genetic aberrations present in multiple myeloma cells play a significant role in the risk stratification and therapeutic approach in patients, determining the best course of treatment can be difficult. Furthermore, patients with more aggressive disease experience suboptimal responses to some therapeutic approaches; therefore, identifying these patients is critically important for selecting appropriate treatment options.
Mayo Stratification for Myeloma and Risk-Adapted Therapy (mSMART) represents a consensus opinion on the utilization and assessment of genetic markers in multiple myeloma. The mSMART algorithm classifies patients into either standard or high-risk categories based on the results of 3 assays: the plasma cell proliferation result, conventional chromosome analysis, and FISH for specific multiple myeloma-associated abnormalities.
- Additional diagnostic and prognostic testing resources for multiple myeloma
- View additional treatment guidelines at mSMART.org