COMy 2026 | Genomic sequencing guides personalized treatment in multiple myeloma

I think because of the new definition of risk, sequencing is now necessary to define the risk. So we are now getting away from doing FISH and sequencing all patients to identify what genomic changes they carry. I think it’s very important that it be utilized at the time of diagnosis. And then if a patient relapses, then also repeat it at that time. And the reason is that the genomes evolve. A patient may start with one type of myeloma characteristics. When they relapse, they may acquire something new. And we may need different drugs or a different approach. And so doing sequencing-based analysis for diagnosis, especially the genomic changes, is critically important. As we have discussed in other talks, we have drugs that can be considered for some of these genomic changes and utilization of drugs earlier on in combination, not by themselves, is also a very important component of how we will pursue this patient. So doing an appropriate assessment of their genomic characteristics is important. One more point, immunotherapy is wonderful. BCMA is a great target. GPRC5D is a very important target. What we have learned is that patients getting this very effective therapy evolve the disease with mutations in this gene. So the newer sequencing technologies do look at these specific genes, which are our immune targets. So knowing about their presence or absence, if there’s a loss of gene or not, is also important in deciding whether I should give BCMA followed by GPRC5D or I should do something else. And so this kind of analytical approach for genomics is becoming important and a mainstay in the treatment of the present.

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