Precision Medicine in Myeloma: Challenges in Defining an Actionable Approach

Clin Lymphoma Myeloma Leuk. 2017 Oct;17(10):621-630. doi: 10.1016/j.clml.2017.06.021. Epub 2017 Jun 23.

Abstract

Recently, large sequencing studies have provided insights into the mutational landscape of multiple myeloma (MM), identifying actionable mutations and giving a precious opportunity for exploring new targeted therapies. The main goal of precision medicine, matching patients with the right drug, seems to be closer than ever. However, no targeted therapies in MM are approved yet. Several clinical trials testing targeted drugs and enrolling patients with MM are currently ongoing and will provide predictive biomarkers that might support clinical decision making. In this review, we evaluate the evidence supporting the implementation of precision medicine in MM and we discuss the challenges that should be dealt with in this imminent and promising new era.

Keywords: Actionable mutation; Driver; Immunotherapy; Multiple myeloma; Target therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Apoptosis / drug effects
  • Apoptosis / genetics
  • Biomarkers, Tumor
  • Cyclin D1 / genetics
  • DNA Repair / drug effects
  • DNA Repair / genetics
  • Gene Expression Regulation, Neoplastic / drug effects
  • Genes, myc
  • Humans
  • Immunotherapy
  • Mitogen-Activated Protein Kinases / metabolism
  • Molecular Targeted Therapy
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / etiology
  • Multiple Myeloma / metabolism
  • Multiple Myeloma / therapy*
  • Phosphatidylinositol 3-Kinases / metabolism
  • Precision Medicine* / methods
  • Prognosis
  • Proto-Oncogene Proteins c-akt / metabolism
  • Receptor, Fibroblast Growth Factor, Type 3 / genetics
  • Receptor, Fibroblast Growth Factor, Type 3 / metabolism
  • Signal Transduction / drug effects
  • TOR Serine-Threonine Kinases / metabolism
  • Translocation, Genetic
  • ras Proteins / genetics
  • ras Proteins / metabolism

Substances

  • Biomarkers, Tumor
  • Cyclin D1
  • Receptor, Fibroblast Growth Factor, Type 3
  • Proto-Oncogene Proteins c-akt
  • TOR Serine-Threonine Kinases
  • Mitogen-Activated Protein Kinases
  • ras Proteins