‘Good-Risk’ Myeloma: Study Finds Genomic Markers Prognostic of Prolonged Survival
Posted: Sunday, November 1, 2020
According to research published in the Journal of Clinical Oncology, patients with multiple myeloma who had a genomic scar score of 5 or less plus chromosome 9 gain appeared to be more likely to experience prolonged survival than did patients with a genomic scar score above 5. Whole-genome sequencing was used to identify patients within what Nikhil C. Munshi, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues referred to as a “good-risk” group.
“Interestingly, the superior outcome group identified here was independent of traditional clinical risk factors, such as ISS [International Staging System], response to treatment, and achievement of [minimal residual disease] negativity,” noted the authors.
The study included data on 183 patients newly diagnosed with multiple myeloma who had been treated with either lenalidomide/bortezomib/dexamethasone alone or with autologous stem cell transplantation. Using allele-specific copy-number alterations, a genomic scar score was determined for each patient. A total of 17% of patients were found to have low DNA damage, defined as a genomic scar score of 5 or less plus chromosome 9 gain.
The overall survival for this patient subgroup was 100% at 69 months. A lower mutational load, the substantial influence of age-related mutations, and frequent NRAS mutation were characteristic of this subgroup. When compared with other groups, this subgroup had a significantly reduced mutational load (P = .0002). Patients within the hyperdiploid myeloma subgroup had the lowest load, whereas those within the t(14;16) myeloma subgroup had the highest load (P = .004).
“Identifying these good-risk patients will affect clinical research and inform therapeutic algorithms in the future,” the author concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.