CoMMpass RNA sequencing data has identified 12 subtypes of myeloma. These subtypes can be related back to DNA alterations, some of which are actionable, meaning there is a therapy available that can target and treat that alteration.
These findings led directly to the MMRC MyDrug study (Myeloma - Developing Regimens Using Genomics), the clinical trial that puts these CoMMpass learnings into action.
CoMMpass genomic data showed that myeloma patients can have specific DNA changes, or mutations, that are associated with cancer. Drugs that target these mutations are already approved for other cancer types and are effective. Through the MyDRUG
trial, these drugs are available for the first time to myeloma patients.
CoMMpass genomic data is helping doctors identify which patients have high-risk myeloma and may need to be treated differently than standard-risk patients.
- The common FISH test can identify high-risk patients but can be inaccurate. The new NGS DNA sequencing genomic test is much more accurate, leading to better treatments for high-risk patients. Patients should ask their doctor if the NGS test is available.
- Through CoMMpass we have learned that 10% of myeloma patients have an IgL translocation; we have also found that these patients do not respond well to Revlimid or Pomalyst. Patients with t(IgL) (detected by a clinical test now under development) will soon be treated with more appropriate therapies and may have improved outcomes.
- CoMMpass continues to identify new high risk patient groups, such as those who have lost their TP53 gene, and those who are t(4;14) who also have a mutated FGFR3 gene. Researchers are now working on developing new therapies to help patients in these groups.
- CoMMpass data has identified a marker for patients at high risk of progression. 25% of all patients transition to this “PR” group when they relapse, and they tend to have a shorter time of remission and worse outcomes. Identifying patients in the PR group and providing new targeted therapy options may lead to better outcomes.
African Americans have twice the risk of developing MM compared to other ethnicities and are twice as likely to die from the disease. CoMMpass data has shown that:
- African Americans tend to have a lower-risk form of myeloma compared to other ethnicities.
- African Americans enrolled in the CoMMpass Study (they make up 17% of the CoMMpass patient population) have overall survival rates just as good as or better than other ethnicities.
This information gleaned from CoMMpass points to the conclusion that if African American patients receive treatment equal to other patients, their outcomes are as good as or better than other ethnicities. This has implications regarding treatment disparities and cultural differences that can be addressed in the community to improve the outcomes of African Americans with multiple myeloma.