New genetic test could identify 'high risk' bone marrow cancer patients

A new way of identifying high-risk bone marrow cancer may help predict which patients will have more aggressive disease.

A small proportion of patients with multiple myeloma, a type of bone marrow cancer, show poor response to standard treatment and a lower survival rate. Researchers have found that by studying the genetic features (or 'signatures') of a patient's cancer, they are able to predict which patients will develop more aggressive disease. By identifying these 'high risk' patients earlier on, the researchers hope clinicians will be able to make more personalised treatment choices to improve survival.

'Not all patients with myeloma are the same, and we know that by better understanding their cancer's genetic and molecular features, we can tailor their treatment much more effectively,' said study leader Dr Martin Kaiser from the Institute of Cancer Research (ICR), London.

The study, published in the journal Leukemia, looked at 329 patients from a Phase III clinical trial that is studying the effectiveness of different drugs for the treatment of multiple myeloma. Researchers searched for two particular genetic signatures in each sample, and found that if a cancer had both, the patient had an 11-fold increased risk of death. In addition, these patients were less likely to respond to standard treatment with lenalidomide, a drug which is able to stop cancer coming back in lower-risk patients.

Sarah McDonald, director of research at the charity Myeloma UK, welcomed the research:

'We are aware that myeloma isn't a "one size fits all" cancer and treatment needs to become more personalised. This paper on the innovative research undertaken by the ICR team is a huge step forward.'

While some genetic tests for multiple myeloma already exist, this is the first time researchers have looked at a combination of genetic features to predict disease severity. These findings could help clinicians better divide patients into sub-groups, to give each patient more personalised treatment.

Next, the team plan to use their findings in a larger clinical trial, which will test new combinations of different drugs in these high-risk patients.

Professor Paul Workman, chief executive of the ICR, said: 'It will be exciting to see whether targeting these highest-risk patients with an intensive new treatment can improve survival.'