The Tao of myeloma

Author:

Boise Lawrence H.12,Kaufman Jonathan L.1,Bahlis Nizar J.3,Lonial Sagar1,Lee Kelvin P.4

Affiliation:

1. Departments of Hematology and Medical Oncology and

2. Cell Biology, Winship Cancer Institute of Emory University and the Emory University School of Medicine, Atlanta, GA;

3. Division of Hematology, University of Calgary, Calgary, Alberta, Canada; and

4. Departments of Immunology and Medicine, Roswell Park Cancer Institute, Buffalo, NY

Abstract

Abstract Multiple myeloma is a plasma cell malignancy in which significant advances have been observed during the last 15 years. Our understanding of the disease has been advanced through its molecular characterization. We have also seen improvements in patient care with the development of 2 new classes of active agents, proteasome inhibitors and immunomodulatory drugs (IMiDs), resulting in a significant improvement in overall survival of myeloma patients such that it can now be debated as to whether some subsets of myeloma patients can be cured. However, the advances in our understanding of myeloma biology occurred in parallel with advances in treatment as opposed to being directly informed by the research. Moreover, the molecular characterization of malignant plasma cells would not have predicted the effectiveness of these novel therapies. We hypothesize that proteasome inhibitors and IMiDs are highly active because malignant plasma cells are constrained by many of the characteristics of their normal counterparts and these novel therapies target both normal plasma cell biology and the cancer biology of myeloma. Thus, a better understanding of normal plasma cell biology will likely yield as many actionable targets as mapping the genomic landscape of this disease.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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