Perspectives on the Risk-Stratified Treatment of Multiple Myeloma

Author:

Davies Faith E.1ORCID,Pawlyn Charlotte23ORCID,Usmani Saad Z.4,San-Miguel Jesus F.5ORCID,Einsele Hermann6,Boyle Eileen M.1ORCID,Corre Jill7ORCID,Auclair Daniel8,Cho Hearn Jay89ORCID,Lonial Sagar10,Sonneveld Pieter11,Stewart A. Keith12,Bergsagel P. Leif13ORCID,Kaiser Martin F.314ORCID,Weisel Katja15,Keats Jonathan J.16ORCID,Mikhael Joseph R.17ORCID,Morgan Kathryn E.18,Ghobrial Irene M.19,Orlowski Robert Z.20ORCID,Landgren C. Ola21ORCID,Gay Francesca22ORCID,Caers Joseph23,Chng Wee Joo242526ORCID,Chari Ajai9ORCID,Walker Brian A.24ORCID,Kumar Shaji K.25ORCID,Costa Luciano J.26ORCID,Anderson Kenneth C.19ORCID,Morgan Gareth J.1ORCID

Affiliation:

1. 1Perlmutter Cancer Center, NYU Langone, New York, New York.

2. 2Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.

3. 3The Royal Marsden Hospital, Department of Haematology, London, United Kingdom.

4. 4Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

5. 5Clinica Universidad de Navarra, CIMA, IDISNA, CIBERONC, Pamplona, Spain.

6. 6Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.

7. 7Unité de Génomique du Myélome, Institut Universitaire du Cancer, Toulouse France. 8Institut National de la Santé et de la Recherche Médicale, Paris, France.

8. 9The Multiple Myeloma Research Foundation, Norwalk, Connecticut.

9. 10Multiple Myeloma Center of Excellence, Icahn School of Medicine at Mt. Sinai, New York, New York.

10. 11Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.

11. 12Erasmus MC Cancer Institute, Department of Hematology, Rotterdam, the Netherlands.

12. 13University Health Network and the Princess Margaret Cancer Centre, Toronto, Ontario, Canada.

13. 14Department of Medicine, Mayo Clinic, Arizona.

14. 15Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom.

15. 16Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

16. 17Integrated Cancer Genomics, Translational Genomics Research Institute, Phoenix, Arizona.

17. 18Translational Genomics Research Institute, City of Hope Cancer Center, Phoenix, Arizona.

18. 19Myeloma Patients Europe, Brussels, Belgium.

19. 20Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.

20. 21Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas.

21. 22Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida.

22. 23Division of Hematology, University of Torino, Torino, Italy.

23. 24Department of Hematology, Centre Hospitalier Universitaire (CHU) de Liège, Liège, Belgium.

24. 28Melvin and Bren Simon Comprehensive Cancer Center, Division of Hematology Oncology, Indiana University, Indianapolis, Indiana.

25. 29Department of Hematology, Mayo Clinic, Rochester, Minnesota.

26. 30Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Abstract

Summary: The multiple myeloma treatment landscape has changed dramatically. This change, paralleled by an increase in scientific knowledge, has resulted in significant improvement in survival. However, heterogeneity remains in clinical outcomes, with a proportion of patients not benefiting from current approaches and continuing to have a poor prognosis. A significant proportion of the variability in outcome can be predicted on the basis of clinical and biochemical parameters and tumor-acquired genetic variants, allowing for risk stratification and a more personalized approach to therapy. This article discusses the principles that can enable the rational and effective development of therapeutic approaches for high-risk multiple myeloma.

Publisher

American Association for Cancer Research (AACR)

Subject

General Medicine

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