title: New Targets and New Agents in High-Risk Multiple Myeloma.
abstract: Advances in the treatment of multiple myeloma have resulted in dramatic improvements in outcomes for patients. The newly emerging profiling of mutations emerging as a consequence of large prospective sequencing studies such as the CoMMpass Study or other efforts from European investigators are not further helping to define the place and role for personalized medicine in myeloma. While mutations such as NRAS, KRAS, and BRAF do occur in myeloma, it is not clear that targeting them as a single drug strategy will result in meaningful responses or durations of response. Personalized medicine in multiple myeloma at this time likely entails the use of risk-based approaches for maintenance therapy, the use of current biology-based treatments such as proteasome inhibitors, and immunomodulatory agents, with an eye towards the use of mutation-specific treatments in the setting of minimal residual disease or in concert with biology-based treatments overall.
authors.affiliation: From the Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA.
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Nooka
authors.affiliation: From the Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA.
authors.forename: Sagar
authors.initials: S
authors.lastname: Lonial
mesh_terms: D019496:Cancer Vaccines / Q000627:therapeutic use; D020558:GTP Phosphohydrolases / Q000235:genetics; D006801:Humans; D056747:Immunomodulation; D008565:Membrane Proteins / Q000235:genetics; D058990:Molecular Targeted Therapy; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000517:prevention & control; D009154:Mutation; D057285:Precision Medicine; D061988:Proteasome Inhibitors / Q000627:therapeutic use*; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D018570:Risk Assessment; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D019496:Cancer Vaccines; C117307:KRAS protein, human; D008565:Membrane Proteins; D061988:Proteasome Inhibitors; D013792:Thalidomide; C467566:pomalidomide; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D020558:GTP Phosphohydrolases; C579846:NRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras)