Disease heterogeneity, prognostication and the role of targeted therapy in multiple myeloma

Abstract

Multiple myeloma (MM) is a clonal plasma cell malignancy with a heterogeneous disease course. Insights into the genetics of the disease have identified certain high-risk cytogenetic features that are associated with adverse outcomes. While the advances in therapy have translated into dramatic improvements in the outcome of patients with MM, those with high-risk genetic features continue to perform poorly. This has resulted in a need for clinical trials focusing on the high-risk subgroup of MM as they search for additional biomarkers and therapeutic targets continue. In this review, we discuss the currently existing data on prognostic and predictive biomarkers in MM and speculate the role of treatment stratification based on the genetic features of the disease.

Keywords:

• Gene expression profiling
• cytogenetics
• high risk
• mutations
• personalized therapy

Disclosure statement

Dr. Shaji Kumar – research funding for clinical trials to the institution: Celgene, Takeda, Janssen, BMS, KITE, Merck, Abbvie, Medimmune, Novartis, Roche-Genentech, Amgen, Tenebio, Carsgen; Consulting/Advisory Board participation (with no personal payments): Celgene, Takeda, Janssen, Abbvie, Genentech, Amgen, Molecular Partners and (with personal payment) Oncopeptides, Genecentrix, Cellectar. Dr. Saurabh Zanwar has no relevant conflicts of interest to disclose.