Benefits of Genome Sequencing in Multiple Myeloma

New York—DNA and RNA sequencing improve the ability to provide personalized treatment to patients with multiple myeloma, and are feasible and effective in patients with relapsed disease, according to Samir Parekh, MBBS, Associate Professor, Medicine, Hematology and Medical Oncology, Mount Sinai, New York, who presented this information at the 2018 Lymphoma & Myeloma congress.

What Is a Genome and How Do We Use It?

A genome encompasses the genetic material of an organism. An opening anecdote about the origin of the term “genome” left attendees laughing in their seats as Dr Parekh described a drunken discussion over beers that led to the development of the word.

“The word ‘genome’ was developed to encompass all the single-gene discoveries that had been made between the mid-1970s and mid-1980s and it stuck,” he said, before diving into how the genome is used in the myeloma setting.

“We take the genome from the patient’s cell and fragment it into little bits,” he explained. “These bits are put into a machine. In this machine these little bits are read out 1 base pair at a time, and the computer puts together or reassembles the genome at the end.”

Whole Genome Sequencing and RNA Sequencing

According to Dr Parekh, whereas whole exome sequencing studies a patient’s entire coding region, whole genome sequencing provides information about all coding and noncoding large structural variations that can be missed with exome sequencing.

“We are now taking this to the next level where instead of sequencing bulk cells we are sequencing single cells,” he said.

The benefit of this sequencing is that it leads to clone-specific recommendations for personalized treatment.

He also spoke to the benefits of incorporating RNA sequencing to identify and quantify RNA in biological samples; this helps to keep track of the continuously evolving cellular transcriptome, and of the disease as it progresses.

However, these aren’t the only ways that this process has improved over the years.

Forward Thinking

According to Dr Parekh, there is a new, noninvasive way to track disease burden that is currently being implemented—peripheral blood cell free DNA sequencing.

In addition, he brought up the subject of clinical trials that are currently targeting neoantigens using personalized, cancer-specific vaccines in the multiple myeloma setting. 

“In summary I’d like to say that DNA- and RNA-sequencing–based drug repurposing is feasible and useful in relapsed myeloma patients…. We also need to incorporate more drugs that are emerging that target the microenvironment,” he concluded.—Hina Khaliq