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IMS 2024 | Identifying high-risk myeloma: looking beyond cytogenetic factors
Wee Joo Chng, MB ChB, MRCP, MRCPath, PhD, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, discusses important non-cytogenetic factors that should be considered when defining and identifying high-risk multiple myeloma. These include clinical factors (age, frailty, extramedullary disease) and non-cytogenetic biomarkers such as circulating tumor cells (CTCs). This interview took place at the 21st International Myeloma Society (IMS) Annual Meeting, held in Rio de Janeiro, Brazil.
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Transcript
You know, there is this new classification for high-risk disease based on cytogenetics, which is a very important step forward for the field. But I think it’s important to acknowledge that there are other factors that are also important in defining high-risk disease. And this may include clinical factors like age, frailty, extramedullary disease is important. There are also other non-cytogenetics-based biomarkers, circulating tumor cells, gene expression profiles of the tumor population, certain subtypes of myeloma like IgD myeloma is associated with high-risk as well...
You know, there is this new classification for high-risk disease based on cytogenetics, which is a very important step forward for the field. But I think it’s important to acknowledge that there are other factors that are also important in defining high-risk disease. And this may include clinical factors like age, frailty, extramedullary disease is important. There are also other non-cytogenetics-based biomarkers, circulating tumor cells, gene expression profiles of the tumor population, certain subtypes of myeloma like IgD myeloma is associated with high-risk as well. And then the clinical behavior of a patient. So if a patient is not responding to your treatment or have early progression following treatment, so these so-called functional high-risk patients, they are actually extremely high-risk and a lot of these functional high-risk patients or rather a substantial proportion of them do not have these high-risk genetics at diagnosis. So currently we still don’t have great ways to identify these patients at diagnosis. We can only identify them when they progress or they don’t respond to treatment. So that remains a major kind of unmet need for us.
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