Dr. Faith Davies, from the UAMS Myeloma Institute, and Dr. Brian Walker, from the University of Arkansas for Medical Sciences, share how tests showing abnormalities in gene expression can help classify myeloma patients, and how this information can help improve care for myeloma patients.
I think there are two ways of viewing genetic testing. There’s the genetic testing you see advertised on the television; Chromosome and Me and My Heritage.
That’s not what we’re talking about.
Then there’s my genetic testing about will my family get myeloma? And then there’s the genetic testing about what are the characteristics about my own myeloma and what can that tell the doctor.
So what we’re really going for… I want to see if I read this correctly: a gene expression profile. Is that correct? He’s got to get a microphone. You have to share with this gentleman.
Yeah, that’s right so gene expression profiling or GEP, you might know it as, as well. This is kind of a technique that’s been around for about 10 years or so which scientists at the Myeloma Institute developed to determine patients who are at high risk, so high-risk disease; people who are less likely to respond to traditional therapies. And so this is where we take the dreaded bone marrow samples. We purify.
It’s your fault, too.
Yep, afraid so. We take those cells and purify out the myeloma cells. So when you take the bone marrow sample, there’s lots of blood there and other immune cells and bone cells, and it’s important that we purify the tumor cells so that we get a good signal from those. And we extract various moleculesfrom that, so DNA and RNA.
And from the RNA we can see which genes are turned on in those myeloma cells. Depending on which genes are turned on can tell you whether you are more likely to be a high-risk or low-risk patient, which is important for these guys in the clinic to know, so they can best determine the treatment strategy.
So from this genetic profiling, it sounds to me like what you’re saying is there’s not just one form of multiple myeloma.
Yes, definitely. So as I said earlier, we can subdivide myeloma lots of different ways. There are different ways in which the DNA is changed in a patient’s tumor cells.
There’s likely to be five or six main groups that we subdivide patients into, and then from that you can constantly subdivide each of those again and again, using different methods. We talk about gene rearrangements, we talk about changes in the number of chromosomes in the tumor, and then also looking at changes in actual genes as well. And so some of these ideas are more developed and are translatable into the clinic, and then other ones are newer research ideas that we can then try and find new drugs for which would be good for patient benefits.
Published By :
Nov 10, 2017
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