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Landmark Myeloma Study Should Advance Personalized Treatment for Patients

Value-Based Care in Myeloma - Multiple Myeloma
Caroline Helwick

A landmark myeloma clinical trial is under way, aimed at uncovering the molecular variations that are underpinning the development and progression of multiple myeloma. The goal is to create an unprecedented data set that will facilitate clinical trials in patients with myeloma and serve as a foundation for personalized care for patients with this type of malignancy.

The Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile (CoMMpass) trial is the centerpiece of the Multiple Myeloma Research Foundation’s (MMRF) Personalized Medicine Initiative. The goal is to propel the translation of molecular insights into new clinical strategies and therapeutic breakthroughs.

The CoMMpass study will enroll at least 1000 newly diagnosed, symptomatic patients with myeloma who have not yet initiated treatment. Researchers will track patients from initial diagnosis through treatment over at least 5 years, and conduct sequential tissue sampling to identify how the patient’s molecular profile may affect his or her clinical progression and individual response to treatment.

Some 39 sites are currently enrolling patients in the CoMMpass trial, including 17 US oncology–affiliated clinics, such as Virginia Cancer Specialists in Fairfax, VA; John Theurer Cancer Center at Hackensack University Medical Center, NJ; Waverly Hematology Oncology in Cary, NC; Mount Sinai School of Medicine in New York, and others.

Unprecedented Genomic Evaluations

Carolyn Hoban, ScD, MMRF Director of Translational Research, explained the details of the study design, which involves serial collection of paired bone marrow aspirates and peripheral blood throughout the study to comprehensively catalog genomic changes in individual patients with myeloma. The collections will occur at baseline, then at suspected complete response, and at disease relapse or progression. Evaluations of the biospecimens will include:

  • Whole genome, whole exome, and RNA sequencing
  • Immunophenotyping (ie, study of the proteins expressed by cells)
  • BRAF sequencing (BRAF mutations are present in 4% of patients with myeloma)
  • Chromosomal alterations and ploidy by cytogenetic and fluorescence in situ hybridization analysis.

“Altogether, these efforts will provide an unprecedented myeloma data set on copy number variation, mutation, and levels of gene expression,” Dr Hoban said.

“Bold” and “Ambitious” Collaborative Approach

“Innovation of this magnitude requires a bold, ambitious, and highly collaborative approach to science. As a trusted third party, the MMRF alone was able to bring together a phenomenal team of academic institutions and community cancer centers nationwide to really drive the CoMMpass study forward,” said Kathy Giusti, Founder and Chief Executive Officer of the MMRF and Multiple Myeloma Research Consortium, and a patient with myeloma.

Principal investigator David S. Siegel, MD, PhD, Chief of the Multiple Myeloma Section at John Theurer Cancer Center, called the study “truly innovative,” and said that the CoMMpass trial promises to provide information that could be applied to more targeted treatment, “both in the near-term, with currently available therapies, and in the long-term, with even more advanced therapies that will be developed based on data from the study.”

“This study is designed to build upon our most recent discovery, which is the completion of the first genomic portrait of multiple myeloma,” Dr Siegel said. “We hope to gain a greater understanding of the mechanisms of the disease to develop personalized treatments for our patients.”

Gregory J. Orloff, MD, a hematologist oncologist at Virginia Cancer Specialists, Fairfax, added that the new drugs developed based on the data output of this initiative may notably improve the outlook of patients whose disease relapses or becomes refractory to current treatments.

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Last modified: May 20, 2015
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