ASH 2020 | Genomic and transcriptomic analysis of R/R myeloma in the Phase III BELLINI study

Michael O’Dwyer, MD, PhD, National University of Ireland, Galway, Ireland, discusses the findings of a genomic and transcriptomic landscape analysis of relapsed/refractory (R/R) multiple myeloma patients treated in the Phase III BELLINI trial (NCT02755597). BELLINI randomized patients to receive bortezomib plus dexamethasone (Bd) or Bd plus venetoclax. To gauge the influence on clinical outcomes, the study assessed cytogenetic aberrancies and mutations and carried out RNAseq transcriptomic analysis. The results showed that the 290 treated patients had highly heterogeneous mutations, the most common being MAPK pathway mutations. Patients with a high mutational load showed reduced progression-free survival (PFS) and overall survival (OS) in both arms of the trial, compared to those with a low mutational load. PFS improvement with venetoclax and Bd in key biomarker subgroups (based on BCL expression and t(11;14) presence) was shown to be independent of gene expression profile (GEP) classification. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.