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Can Genetic Profiles Change During Treatment?

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Published on November 16, 2017

Is it possible for genetic profiles to change during treatment? Dr.. Brian Walker and Dr. Frits van Rhee from the UAMS Myeloma Institute discuss the possibility of genetic mutations occurring and what it means for treatment. Watch now to find out more.

This town meeting is sponsored by Amgen, Janssen Pharmaceuticals and Takeda Oncology. It is produced by Patient Power in partnership with the UAMS Myeloma Institute.

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University of Arkansas for Medical Sciences Myeloma Center

Transcript | Can Genetic Profiles Change During Treatment?

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.

Jeff Folloder:

Do the genetic profiles change after treatment?

Dr. Walker:      

First of all, I'd say that we don’t know everything yet.

Jeff Folloder:   

You’ve got another hour or two.

Dr. Walker:      

We understand a lot of stuff about the genetics going on in tumor cells, but there’s still a lot to be discovered. So a lot of what the testing so far and research we’ve done is mostly centered around about 2 percent of the human genome. And so there’s the other 98 percent which we still haven’t looked at yet. But as technologies get cheaper for us to use in the labs, we can now go on and look at the rest of the genome and see what other things might be changed in these tumor cells that are important.

It’s not just the genomics, either; it’s about what else is going on in the body as well so the interaction of those myeloma cells with other cells in the body; what is supporting them and their growth and so on. So it’s not just that.

But yes, you’re right as well. During a patient’s treatment or disease course, the genetics can change as well. So some markers don’t change, so some of what we call primary events, so they’re present in the initiating cell and so they’re present in all the cells that are in your tumor. But then during treatment, the resistant cells can adapt and have additional genetic factors which cause them not to respond to the treatment that the patient might be on. And so we can look to see how these changes happen during the course of a patient’s treatment to try and predict which patients this might happen in.

Dr. van Rhee:  

One thing he said is the CLL example to illustrate one of the important things which is about doing trials in the appropriate setting.

Ten years ago CLL, one disease and then the cytogenetics identified a loss of the short arm of chromosome 17P. And then we viewed the gene called P53 was on that site. And it soon became obvious in CLL that the group with P53 mutations did badly with standard treatment. So now the approach is you do specific trials in that group to try and improve the outcome.

The same thing holds for multiple myeloma where people with P53 mutations do badly. What we need to do now is take the CLL example and really try and drive clinical trials for that type of group. And I think that’s an idea that’s permeating around the pharmaceutical company world, and they’re just beginning to believe that personalized medicine can be beneficial to them.

And once they believe, it will come into clinical practice really quite quickly. 

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.

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