Multiple Myeloma is the second most common cancer of the blood. It represents approximately 1.8% of all new cancer cases in the US and frequently is diagnosed in patients who are greater than 65 years old. It could have devastating effects with low blood counts, decreased kidney function, bone damage, and an overall increased risk of infection.
Precision medicine has been the overreaching quest over the last decade. As we begin to understand the mechanisms driving normal plasma cells to transform into myeloma cells, there has been an explosion of new treatments that have targeted different pathways that cause Myeloma to proliferate. In a disease that may have only had a handful of treatments up until the late 1990s, there have been 15 new drugs that have been approved to treat this disease over the last 11 years. Many of them work synergistically in combination, and offer deeper and quicker remissions, as well as an overall survival benefit. Patients are living longer with multiple myeloma due to these advances.
The cornerstone of these advances are the genomic studies that further aid in drug development. Virginia Cancer Specialists has been an integral part of this research. We started with the CoMMpass study in 2011, in which Multiple Myeloma patients had further genomic analysis of their disease at the initiation of therapy as well as throughout therapy. The initial CoMMpass studies revealed that Multiple Myeloma is quite heterogeneous, even more than previously understood. This longitudinal approach allows us to understand what possible mutations were driving these diseases.
A combination of two previous CoMMpass studies have primed the field for a groundbreaking research study that is soon to open nationally and locally at Virginia Cancer Specialists. The MyDRUG (Myeloma-Developing Regimens Using Genomics) is intended to use information that we have learned in previous studies and to tailor therapy on an individual basis. This is a national study that will allow Myeloma patients to have individual genomic testing, and then based on their mutational analysis be placed into different treatment arms. This approach is the definition of precision medicine and with it comes the hope of optimizing Myeloma treatment response and minimizing its toxicity.
We are excited to be part of these innovative clinical trials, such as the MyDRUG study. It is a very hopeful and exciting time to be treating Myeloma.
Dipti Patel-Donnelly, M.D.