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Is There a Racial or Ethnic Disparity in Myeloma Data?

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Published on January 7, 2019

14 in a 100,000 African Americans are affected by multiple myeloma compared to 11 African-American females, compared to seven Caucasian males compared to three Caucasian females,” says renowned myeloma expert Dr. Ajay Nooka, from the Winship Cancer Institute. Are there biological implications among more frequently diagnosed patient populations? Is there a difference in how effective treatment will be? Tune in to hear Dr. Nooka discuss the latest clinical trial research on race, ethnicity and multiple myeloma. 

This town meeting is sponsored by Amgen, Janssen Pharmaceuticals and Adaptive Biotechnologies. It is produced by Patient Power in partnership with Winship Cancer Institute of Emory University.

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Transcript | Is There a Racial or Ethnic Disparity in Myeloma Data?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jack Aiello:

Dr. Nooka, I saw that the NCI just awarded you a grant, and it's a grant on a racial and ethnic disparity study for myeloma in African-Americans.  So I'm—that's a trial in some sense.  It's a grant at least.  Can you say a little bit more about that?  

So going back, he was the one that defined these tumors, and this is all from a county called Olmsted County in Minnesota.  So whatever has involved from there in terms of the data, it has all evolved from a group of patients who are 97 percent Caucasian.  So what we use in terms of a staging system today is all based on the same data.  

So when you clearly see African-Americans have a higher predilection for multiple myeloma, if I were to give you the numbers, 14 in a 100,000 African-Americans are affected compared to 11 African-American females compared to seven Caucasian males compared to three Caucasian females.  So there is a huge disparity that we see, but yet we don't know the biological implications of the treatment.  We don't know reason for the biological myeloma genesis, right, why myeloma happens so frequently among these patients.  

There are several trials that are ongoing, but to have a data set to look at the biology of the differences and the immunological correlations is what we're looking at, and that's what we proposed.  We wanted to see these 100 African-American MGUS or the smoldering myeloma precursor states to look into their bone marrow to look for the real biological correlates that can help us to open up the reasons why these patients have higher instance of MGUSes and why they're present earlier on.  

Dr. Nooka:

You ask a great question. So we looked at—take our own database from 1,000 patients that are treating with RVD.  They've been on RVD, got a transplant, got maintenance, and these are the patients that had had access to these drugs.  So, by the difference by the race, our African?American patients did exactly the same, got the same benefit, did the exactly the same compared to the whites.  

So if the treatments are—again, these are not, when we're treating we are not selecting out for a patient like who we give RVD.  We give RVD to everyone.  These were risk agnostic, how we treat.  So when we are giving a uniform treatment option to both the groups of people, everybody gets the same kind of a benefit at this point of time.   

Having said that, there's some biological differences of what African-Americans (?) host in terms of the genetics, different than the Caucasians.  We're getting more and more data now at this point in time that African-Americans have a little bit risk disease than the Caucasians, and they presented almost five years earlier than the Caucasians.  So it's yet to—we have yet to unravel exactly the question you asked, like if the same treatment is given to this particular patient and he has a high-risk disease, they should get more benefit, why we are not seeing that. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.