ASH 2020 | High-dose melphalan increases the mutational load in myeloma cells at relapse
Mehmet Samur, PhD, Dana-Farber Cancer Institute, Boston, MA, discusses the findings of an analysis of genomic changes in multiple myeloma cells induced by high-dose melphalan (HDM) based on a 2009 study (NCT01191060). Paired samples from diagnosis and relapse were sequenced from a study treating patients with lenalidomide-bortezomib-dexamethasone (RVD) or HDM +RVD. While mutational load increased from diagnosis to relapse in both cohorts, the increase was significantly higher in the HDM + RVD arm, particularly in terms of single point mutations. No differences in the number of copy number alterations or structural variants were seen. These results identify a need for the re-evaluation of optimal HDM use in multiple myeloma. Further research is underway to determine the clinical significance of the increased mutational load following HDM treatment. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.
