June 3, 2009

Challenges and Opportunities for Personalized Medicine, Susan Kelley, MD, Chief Medical Officer

The data presented at the Annual ASCO meeting on new investigational drugs are of interest to all oncology researchers, and the opportunity to gather with large groups of oncology researchers to review and discuss these results is a critical part of the information exchange process in this field. There were approximately 175 abstracts presented from studies in multiple myeloma, including results from clinical studies ongoing within the MMRC clinical trials network. In addition, there were very informative presentations and discussions on early clinical trials of new drugs against pathways and targets that are relevant to myeloma, even if the study under discussion did not include patients with multiple myeloma. It is these early data that help the researchers in myeloma decide whether to investigate some of these emerging drugs in trials specific for multiple myeloma.

The theme of this year’s congress was “Personalized Medicine “. The entire field of oncology clinical research is at an important crossroads. We now understand enough of the biology of cancers, and have new drugs emerging that allow us to begin to tailor specific drug therapy against the molecular pathways to which a particular tumor, or indeed, a particular patient’s tumor, is especially “addicted” for growth. This will not be a short term effort. The tools for genomic and proteomic analysis need to be applied in a more widespread manner, in carefully constructed clinical trials, with the goal of matching patients with particular drugs or drug combinations. The field of myeloma research is well equipped to pursue this goal of personalized medicine. The scientific and clinical researchers who are our partners in the quest to develop new drugs to improve patient outcomes, and ultimately attain cures, in multiple myeloma, have already been collecting bone marrow samples for important analyses. The next step is to organize a large effort in partnership with our research partners and stakeholders, to design these clinical studies where patient treatment is assigned according to biologic markers and risk factors for a given patient. We cannot stress enough how important it will be for patients to participate in clinical trials as we attempt to move this field forward.

In addition to the efforts around personalized medicine, there were clinical trial results and discussions about important therapeutic issues in myeloma presented at ASCO. For example, with the improved outcomes reported as a result of treatment with the newer drugs that have become available for myeloma in the past 4 years, there are now questions raised about the optimal timing of autologous stem cell transplant—which patients, when and after how much initial therapy? All patients should continue to engage in these important discussions with their physicians.