Genomic profiling to contextualize the results of intervention for smoldering multiple myeloma Journal Article


Authors: Kazandjian, D.; Diamond, B.; Papadimitriou, M.; Hill, E.; Sklavenitis-Pistofidis, R.; Ziccheddu, B.; Blaney, P.; Chojnacka, M.; Durante, M.; Maclachlan, K.; Young, R.; Usmani, S.; Davies, F.; Getz, G.; Ghobrial, I.; Korde, N.; Morgan, G.; Maura, F.; Landgren, O.
Article Title: Genomic profiling to contextualize the results of intervention for smoldering multiple myeloma
Abstract: Purpose: Early intervention for high-risk smoldering multiple myeloma (HR-SMM) achieves deep and prolonged responses. It is unclear if beneficial outcomes are due to the treatment of less complex, susceptible disease or inaccuracy in clinical definition of cases entered.Experimental Design: In this study, we interrogated whole-genome and whole-exome sequencing for 54 patients across two HR-SMM interventional studies (NCT01572480 and NCT02279394).Results: We reveal that the genomic landscape of treated HR-SMM is generally simple as compared with newly diagnosed multiple myeloma counterparts with less inactivation of tumor suppressor genes, RAS pathway mutations, MYC disruption, and APOBEC contribution. The absence of these events parallels that of indolent precursor conditions, possibly explaining overall excellent outcomes. However, some patients harboring genomic complexity fail to sustain response and experience resistant, progressive disease. Overall, clinical risk scores do not effectively discriminate between genomically indolent and aggressive disease.Conclusions: Genomic profiling can contextualize the advantage of early intervention in SMM and guide personalization of therapy. See related commentary by Weinhold and Rasche, p. 4263Conclusions: Genomic profiling can contextualize the advantage of early intervention in SMM and guide personalization of therapy. See related commentary by Weinhold and Rasche, p. 4263
Keywords: lenalidomide; dexamethasone; risk; progression; mutations; discovery; undetermined significance; monoclonal gammopathy; cancer; structural variants
Journal Title: Clinical Cancer Research
Volume: 30
Issue: 19
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2024-10-01
Start Page: 4482
End Page: 4490
Language: English
ACCESSION: WOS:001325875500008
DOI: 10.1158/1078-0432.Ccr-24-0210
PROVIDER: wos
PMCID: PMC11444893
PUBMED: 38652812
Notes: Article -- Source: Wos
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  1. Neha Sanat Korde
    226 Korde
  2. Saad Zafar Usmani
    296 Usmani