Banner MD Anderson Cancer Center launches lymphoma/myeloma initiative
By Mary Vandeveire
The University of Texas MD Anderson Cancer Center is devoted to developing growing expertise in diverse specific types of malignancies. In support of this commitment, Banner MD Anderson Cancer Center in Gilbert launched a lymphoma/myeloma initiative, offering diagnostic testing and imaging, as well as treatments such as chemotherapy, immunomodulators, radiation therapy and stem cell transplantation.
Main interests of the Banner MD Anderson initiative are to decipher the molecular heterogeneity of multiple myeloma, and sub-classify specific plasma cell dyscrasias amenable to a particular targeted therapy. Javier Munoz, MD, FACP, is among the investigators leading Banner MD Anderson's lymphoma/myeloma initiative. Dr. Munoz is first author of "Molecular profiling and the reclassification of cancer: divide and conquer," a chapter in the American Society of Clinical Oncology Educational Book 2013.
"Making personalized medicine a reality will be the true challenge in years to come," Dr. Munoz says. "Extrapolating data from other malignancies, decoding the genetic blueprint of multiple myeloma, seems to be the way of moving forward in oncology."
Advances in next-generation DNA sequencing technologies allow for faster and less costly testing of tissue specimens. Dr. Munoz notes that recent studies have shown that different genes involved in the nuclear factor (NF)-kappaB pathway seem to be involved in the development of multiple myeloma. Furthermore, a minority of multiple myeloma patients (4 percent) have been found to harbor a BRAF gene mutation that is common in melanoma and colon cancer, perhaps hinting at the possibility of another molecular target in this condition.
"This is a very exciting time in oncology for the treatment of multiple myeloma," Dr. Munoz says. "Various pipeline drugs are currently in clinical trial testing (pomalidomide, daratumumab), soon to be added to the ever-growing roster of FDA-approved drugs for this condition (lenalidomide, bortezomib, carfilzomib). As an example, daratumumab is a monoclonal antibody directed against the CD38 marker, which is highly expressed on the surface of multiple myeloma cells."
The Banner MD Anderson Blood Cancer Program takes a multidisciplinary approach at its weekly Hematology Tumor Board meetings, where difficult cases are discussed by experts in specialties including radiology, pathology, radiation-oncology and stem cell transplantation.
The Banner MD Anderson Stem Cell Transplantation and Cellular Therapy Program is actively receiving referrals of multiple myeloma patients, Dr. Munoz says, noting that autologous transplantation is currently standard of care consolidation after initial response to chemotherapy.
"The advent of the stem cell transplantation program at Banner MD Anderson heralds the opportunity to distinguish ourselves as a center of excellence when treating patients with plasma cell dyscrasias and hematologic malignancies in general," Dr. Munoz says.