Gene Signature in Predicting Response to Immunomodulatory Derivatives in Myeloma
Manisha Bhutani, MD, of Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina, and colleagues have developed a gene-expression signature that may predict response to immunomodulatory derivatives (IMiD) in patients with multiple myeloma. The findings of this retrospective study, which used microarray data sets from prospective clinical trials, were published in The Lancet Haematology.
The investigators identified 176 IMiD response genes that were differentially expressed before and after IMiD exposure. A total of 14 of the genes used had P values less than .05 for association with progression-free survival in patients who received induction and maintenance thalidomide. The 14 genes were combined to create a continuous IMiD-14 score, with those with a high IMiD-14 score considered to be resistant to IMiDs.
The 83 patients with high IMiD-14 scores had significantly shorter progression-free survival than the 92 patients with low IMiD-14 scores. Specifically, the 3-year progression-free survival was 52% in those with high IMiD-14 scores, compared with 85% in those with low IMiD-14 scores.
Drug-specific gene signatures such as the IMiD-14 model may prove to be useful complementary tools for guiding treatment intervention in the era of personalized medicine, the authors concluded. However, they noted, their model requires further evaluation in prospective studies.