Individualized therapy in Multiple Myeloma

Presented by: Shaji Kumar, M.D., Mark and Judy. Mullins Professor of Hematological Malignancies. Chair, Myeloma and Amyloidosis Group, Mayo Clinic, Rochester, MN.

Covered by: Abdul Moiz Khan, M.D, Chief Fellow of Hematology and Oncology at Karmanos Cancer Institute, Detroit, MI.

Dr. Shaji Kumar, a key opinion leader in multiple myeloma (MM), discussed the importance of understanding the drivers of heterogeneity to help individualize treatment for MM patients. These differences are the result of an interplay of multiple host and disease factors. With our improved understanding of disease biology and behavior, MM should be considered a group of disorders with a common morphology, yet distinct genetic subgroups. This may enable personalization of therapy by using multidrug combinations or specific class of drugs, varying the duration of therapy, or targeting a particular level of response.

Venetoclax in t(11;14) MM serves as a prototypical example of precision medicine in MM. Dr. Kumar reviewed our evolving knowledge of MM genome and how basket, umbrella or platform trial designs may pave way for bringing drugs from bench to bedside. He cited the example of Myeloma-Developing Regimens Using Genomics (MyDRUG) (NCT02884102) trial which aims at treating patients with drugs targeted to affect specific mutated genes. Looking ahead, novel targeted therapies carry a promise to achieve the goal of individualized medicine with improved outcomes in MM.

1. Shaji Kumar, et al.Blood 2017; 130 (22): 2401–2409.
2. https://www.cancer.gov/research/participate/clinical-trials-search/v?id=NCI-2019-00698&r=1