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ASCO 2022 | Mutational burden at relapse following exposure to high dose melphalan in multiple myeloma

Paul Richardson, MD, Dana-Farber Cancer Institute, Boston, MA, discusses an investigation into mutational burden at relapse following exposure to high dose melphalan (HDM) compared to no exposure in the tumors of patients with multiple myeloma (MM). Exposure to HDM increases the risk of developing myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) (MDS/AML), particularly in patients with MM. Similar to what has been observed in patients with MDS/AML, mutational burden was significantly higher in patients who had been exposed to HDM. However, the outcome of this was not detrimental, suggesting the mutational burden may generate some immunogenicity. Although a progression-free survival (PFS) advantage was not observed with HDM, an overall-survival (OS) benefit was observed. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.