A very recent article in the journal Nature Medicine presents results from research done at the Weizman Institute of Science in Israel. The ‘easier’ summary of this article can be found here. As multiple myeloma patients, we are constantly reminded that our disease is heterogeneous. In other words, we present ourselves differently, with different symptoms at time of diagnosis, we may react differently to the same courses of treatment, the genetics of our disease are different from patient to patient. The authors wrote,
‘Despite extensive research, disease heterogeneity is poorly characterized, hampering efforts for early diagnosis and improved treatments.’
The team at Weizman set out to solve the problem that …
‘A major stumbling block in diagnosing myeloma is that each patient is unique and current blood tests are incapable of identifying early disease onset and classifying which patient should receive which treatment.’
The study started with a cohort of 40 people, 29 with active multiple myeloma at various stages of progression and 11 healthy controls and then collected and analyzed plasma cells. Plasma cells of healthy people are very similar to each other, but myeloma plasma cells differ widely from patient to patient. The team developed technology that can identify malignant cells, even when present at extremely low levels and despite their many differences from patient to patient, from tens of thousands of cells from either bone marrow or circulating blood.
The RNA of a single cell can then be sequenced to look for myeloma drivers, molecular structures that are the tell-tale signs of the presence of MM. The authors report,
‘In asymptomatic individuals with early disease and in those with minimal residual disease post-treatment, we detect rare tumor plasma cells with molecular characteristics similar to those of active myeloma, with possible implications for personalized therapies.’
The main conclusion here is that patients, even those who are MRD negative, can now be identified earlier than ever with a simple blood test, as opposed to the bone marrow biopsies we love so much, and for our multiple myeloma to be typed accurately early on to allow our physicians to define a treatment plan that is indeed optimal for our personal situation and disease characteristics.
About Author
I am a patient diagnosed in 2014 with primary plasma cell leukemia (pPCL), a rare and aggressive variant of multiple myeloma and have been very fortunate to find treatment at the division of Cellular Therapy at the Duke University Cancer Institute. My wife, Vicki, and I have two adult children and a grandson who is the ‘light of my life’. Successful treatment has allowed Vicki and I to do what we love best : traveling the world, albeit it with some extra precautions to keep infections away. My career in the pharmaceutical industry has given me insights that I am currently putting to use as an advocate to lower drug pricing, especially prices for anti-cancer drugs and, very specifically, CAR-T therapies, with recent contributions posted by Health affairs, the Institute for Clinical and Economic Review and the Centers for Medicare and Medicaid Services.
