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How Genetic Profiling Can Identify Higher Risk Myeloma

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Published on November 16, 2017

What can a genetic profile reveal about your myeloma condition? Join us to hear from experts Dr. Brian Walker, Dr. Guido Tricot and Dr. Frits Van Rhee how information from this diagnostic test can lead to better treatment.

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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Transcript | How Genetic Profiling Can Identify Higher Risk Myeloma

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:

Is it correct to say that by doing this genetic profiling, one, you can identify those types of myeloma that are higher risk?

And then two, is it safe to say with genetic profiling you can identify those patients who will have better outcomes with a specific form of treatment?

Dr. Walker:      

Yes. So your diagnostic tests that the doctor relies on to determine the treatment, these all started off as research tests. So if you’re looking at your bloodwork, looking at your genetics, the gene expression profiling; that all started off as basic research, taking patient samples, seeing what was different between patients and then looking at the statistics, as you said earlier, between which patients do better, which do worse, and which genetic markers are associated with that data.

And so we have taken the gene expression profiling through the research setting. It’s now used as the major clinical test in the MyelomaInstitute where we can decide which patients are more likely to be high risk or low risk.    

Jeff Folloder:   

This is a group discussion.

Dr. Tricot:        

One of the most important things that patients do not fully understand, when we talk about normal genes we talk about normal genes only in the myeloma cells, not in the normal cells. And people think oh, I have all these abnormal genes in my whole body, and my kids have half of my genes. So they must have the same risk as I have, or almost the same risk. The normal cells are normal. It’s only the myeloma cells that have these abnormalities.

And then the second point I would like to clarify is that gene expression profile is really good at identifying who is high risk. But we are not at a stage where we can find patients who are really at very low risk.

My definition of low risk is you have to have a 90 percent chance that you will still be event-free at 10 years. That takes much longer follow-up; finding out what’s bad you see very quickly. Finding out what’s very good takes a long time and long follow-up. So we are not at the stage where we can say this patient has such a good gene expression profile that we can decrease our intensity of treatment and can go to light treatment. Unfortunately, that will take more time.

Jeff Folloder:   

We’ll put you next, I promise.

Dr. van Rhee:  

Apart from guiding treatment, the genetic expression profile obviously is very important. The other thing people are confused about is what is high-risk myeloma? There are a number of definitions out there. We very often have patients who come to us, and they think that they have high-risk disease.

When we evaluate them, we think that they actually fall by our criteria and with our treatment in a low-risk category. If you do have high-risk disease, we have protocols here specifically designed for high-risk disease where we really try to innovate and improve the outcome of these patients. And in some of our most recent protocols, it already looks like the outcome is improving in this important subgroup of patients.

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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