Multiple Myeloma and Gene Sequencing

If you're a patient with multiple myeloma, you'll find the recent progress in deciphering the human genome very exciting and promising.

Multiple myeloma is cancer that forms in plasma cells, a type of white blood cells. When these abnormal (myeloma) cells accumulate in the bone marrow, they interfere with the production and function of normal blood cells. Multiple myeloma is relatively rare and, to date, there are no known risk factors. Former vice-presidential candidate Geraldine Ferraro recently passed away after a long battle with this cancer.

At about the same time Ms. Ferraro died, researchers announced new results from the Multiple Myeloma Genomics Initiative. They uncovered new connections between multiple myeloma and important molecular targets that will hopefully help scientists develop more effective treatments.

The researchers discovered connections between multiple myeloma and several molecular pathways involved in protein production and epigenetic regulation. Epigenetics is the study of changes in the ways inherited genes express themselves or change due to environmental factors.

The scientists also found genes never before associated with multiple myeloma—or any type of cancer—and they've identified mutations found in other types of cancer but never seen in multiple myeloma.

Mutations in these genes disrupt normal chemical reactions. For example, when the NF-kB pathway (one of the pathways recently discovered), is turned on at the wrong time, it can activate genes that allow cancer cells to grow and divide.

According to one of the researchers, each of the mutations they discovered is relatively uncommon. In fact, individually they might have remained undiscovered. However, because the researchers looked at so many patients' genes at the same time, they began to correlate mutations with a limited number of pathways. The research challenge now is to separate the important mistakes that drive cells to become cancerous from what the researchers call passenger mutations, or genetic alterations that are "just along for the ride."

In the meantime, The Massey Cancer Center in Virginia has already developed a new treatment strategy that pairs two targeted agents to kill cancer cells. It works by blocking the activity of a group of proteins that regulate cancer cell behavior, triggering cell death and reducing the formation of new blood vessels, which cancer cells need to grow. Unlike traditional chemotherapy, this combination treatment causes cell death in multiple myeloma cells but does not harm healthy cells.

National Cancer Institute. "Targeted Therapies for Multiple Myeloma Tutorial." Web.

National Cancer Institute. "What you need to know about myeloma." Web. 20 November 2008.

Dana-Farber Cancer Institute. "First look at the full multiple myeloma genome reveals new insights, discoveries." Press Release. Web. 23 March 2011.

VCU Massey Cancer Center.  "VCU Massey First to Combine Targeted Agents to Kill Multiple Myeloma Cells." Press release. Web. 10 February 2011.

Multiple Myeloma Research Foundation. "Multiple Myeloma Research Foundation Announces Publication of First Whole-Genome Sequence Analysis for Multiple Myeloma." Web. 23 March 2011.