Many of the drugs used to treat multiple myeloma have been shown in clinical trials to work in most patients. That is, drugs are chosen for use in a given patient because studies have shown them to be effective in other patients whose myeloma is at a similar stage or has a similar level of risk. These treatments are further tailored to the characteristics of the specific patient, taking into account factors like his or her age, previous treatments, and any other medical conditions that may be present. Overall, the goal of myeloma treatment is to make sure the patient gets the right treatment at the right time, experiences as few side effects as possible, and isn’t under- or over-treated.
However, as the MMRF’s CoMMpass study and the Multiple Myeloma Research Consortium’s Molecular Profiling Initiative have shown, myeloma is not one uniform disease but rather a variety of different disease subtypes defined by different genetic mutations. In other words, an individual’s genetic blueprint determines the type of myeloma he or she has. And, as researchers are learning, the type of myeloma a patient has is one of the most important factors that must be considered when choosing treatment.
Precision medicine—a treatment approach that uses genetic tests to identify the exact myeloma subtype a patient has—is changing the way myeloma treatments are selected and delivered. Using precision medicine, the health care team can individualize treatments to patients based on their specific genetic blueprint. A revolutionary step forward in myeloma management, precision medicine shifts the focus of myeloma treatment from what works best for most patients to what works best for an individual patient.
The genetic testing that enables precision medicine to work at such an individualized level is called genomic sequencing. In this test, myeloma cells are collected from the patient’s bone marrow and analyzed to determine whether any defects (errors) in the DNA are present. These errors, called mutations, are detected by comparing the DNA structures of myeloma cells and normal cells. Some mutations can cause cancer to develop. Fortunately, drugs are available that can block the cancer-causing activity of some mutations. Mutations that can be targeted in this way are called actionable targets (examples include BRAF, NRAS, KRAS, and FGFR3—myeloma patients may hear their doctors mention these mutations when deciding on the best treatment to use). Other mutations can cause changes in myeloma cells such that the body’s immune system can recognize and attack them.
Precision medicine for myeloma continues to be an area of active research, with a number of clinical trials ongoing. The MMRF’s MyDRUG trial is one such study and is currently investigating six separate, targeted myeloma treatments. You can learn more about the MyDRUG trial and other precision medicine trials here. If you would like to join a precision medicine clinical trial—or have questions about joining one—you can contact a Nurse Patient Navigator at the MMRF Patient Support Center at 866-603-6628.
MMRF. The Path to Precision Medicine in Myeloma (brochure).
MMRF. Patient Education Page.
MMRF. MMRF precision medicine model drives new discoveries in multiple myeloma (press release).
MMRF. Pipeline: 2017 active clinical trials [in multiple myeloma].