scholarly journals Correlation between eight-gene expression profiling and response to therapy of newly diagnosed multiple myeloma patients treated with thalidomide–dexamethasone incorporated into double autologous transplantation

2013 ◽  
Vol 92 (9) ◽  
pp. 1271-1280 ◽  
Author(s):  
Carolina Terragna ◽  
Matteo Renzulli ◽  
Daniel Remondini ◽  
Enrico Tagliafico ◽  
Francesco Di Raimondo ◽  
...  
Blood ◽  
2010 ◽  
Vol 116 (14) ◽  
pp. 2543-2553 ◽  
Author(s):  
Annemiek Broyl ◽  
Dirk Hose ◽  
Henk Lokhorst ◽  
Yvonne de Knegt ◽  
Justine Peeters ◽  
...  

Abstract To identify molecularly defined subgroups in multiple myeloma, gene expression profiling was performed on purified CD138+ plasma cells of 320 newly diagnosed myeloma patients included in the Dutch-Belgian/German HOVON-65/GMMG-HD4 trial. Hierarchical clustering identified 10 subgroups; 6 corresponded to clusters described in the University of Arkansas for Medical Science (UAMS) classification, CD-1 (n = 13, 4.1%), CD-2 (n = 34, 1.6%), MF (n = 32, 1.0%), MS (n = 33, 1.3%), proliferation-associated genes (n = 15, 4.7%), and hyperdiploid (n = 77, 24.1%). Moreover, the UAMS low percentage of bone disease cluster was identified as a subcluster of the MF cluster (n = 15, 4.7%). One subgroup (n = 39, 12.2%) showed a myeloid signature. Three novel subgroups were defined, including a subgroup of 37 patients (11.6%) characterized by high expression of genes involved in the nuclear factor kappa light-chain-enhancer of activated B cells pathway, which include TNFAIP3 and CD40. Another subgroup of 22 patients (6.9%) was characterized by distinct overexpression of cancer testis antigens without overexpression of proliferation genes. The third novel cluster of 9 patients (2.8%) showed up-regulation of protein tyrosine phosphatases PRL-3 and PTPRZ1 as well as SOCS3. To conclude, in addition to 7 clusters described in the UAMS classification, we identified 3 novel subsets of multiple myeloma that may represent unique diagnostic entities.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 114-114
Author(s):  
Guido Tricot ◽  
Fenghuang Zhan ◽  
Bart Barlogie ◽  
Yongsheng Huang ◽  
Jeffrey Sawyer ◽  
...  

Abstract The International Staging System (ISS), based on B2-microglobulin and albumin levels at the time of diagnosis, has now generally been adopted as a new prognostic classification system for multiple myeloma (MM). While readily and widely applicable, ISS does not account for genetic disease features, such as metaphase (CA) and interphase fluorescence in situ hybridization (FISH) cytogenetic abnormalities, which when examined in the context of standard prognostic variables, confer higher hazards of relapse and disease-related death. Recently, gene expression profiling (GEP) uncovered the major prognostic significance for outcome of high expression of CKS1B, a gene mapping to an amplicon at chromosome 1q21. We have performed a comprehensive study of CA, FISH, GEP and ISS staging in 351 newly diagnosed MM patients, treated uniformly on Total Therapy 2. We have analyzed outcome based on a combination of high CKS1B by GEP and CA. GEP-based t(11;14) was prognostically favorable, irrespective of expression of CKS1B and, therefore, was removed from the group of patients with high CKS1B expression. After this adjustment, with the combination of both CA and high CKS1B (approximately 10% of all patients) conferred a very poor outcome with only 24% and 40% of such patients being event-free and/surviving at 3 years, compared with 72% and 84% for the others (p values : <.0001). Such patients fared poorly, irrespective of their ISS stage. Similar prognostic information could be gained by combining CA with FISH-defined amplification of 1q21 and t(11;14). Because of their major prognostic impact, all newly diagnosed patients should be tested for these genetic markers. Novel treatment modalities are justified in the small subgroup of such poor prognosis patients, since they derive only a minor benefit from advances in MM therapy. CKS1B Q4 + CA (with no CCND1) vs. Others CKS1B Q4 + CA (with no CCND1) vs. Others


Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1494-1494
Author(s):  
Abderrahman Abdelkefi ◽  
John de Vos ◽  
Said Assou ◽  
Tarek Ben Othman ◽  
Jean-Francois Rossi ◽  
...  

Abstract Background: Thalidomide which represents an effective treatment strategy for relapsed/refractory multiple myeloma, actually represents a standard of care also for newly diagnosed multiple myeloma patients. Methods: In the present study, we adopted a gene expression profiling (GEP) strategy in an attempt to predict response (> 50% reduction in serum M protein) to primary therapy with thalidomide-dexamethasone for newly diagnosed multiple myeloma. Plasma cells (CD138+) were purified from bone marrow aspirates from 17 patients at diagnosis, before initiation of treatment with thalidomide-dexamethasone. GEP was performed using the Affymetrix U133 Plus_2 microarray platform. The Affymetrix output (CEL files) was imported into Genespring 7.3 (Agilent technologies) microarray analysis software, where data files were normalized across chips using GCRMA and to the 50th percentile, followed by per gene normalization to median. Criteria of response were those established by Bladè et al. Results: After sufficient follow-up, responders (n=9) and nonresponders (n=8) were identified, and gene expression differences in baselines samples were examined. Of the 11000 genes surveyed, Wilcoxon rank sum test identified 149 genes that distinguished response from non response. A multivariate step-wise discriminant analysis (MSDA) revealed that 14 of the 149 genes could be used in a response predictor model (see table). Of interest, the gene list encompasses WXSC1, known to be involved in the chromosomal translocation t(4;14) (p16.3;q32.3) in multiple myeloma. Conclusion: These results could be the first step to adopt microfluidic cards, in an attempt to select at diagnosis patients who will respond favourably to a particular treatment strategy. List of 14 genes able to predict response to primary therapy with thalidomide-dexamethasone for newly diagnosed multiple myeloma. Gene ID Gene Name Chromosomal location 212771_at C10orf38 10p13 229874_x_at LOC400741 1p36.13 219690_at U2AF1L4 19q13.12 202207_at ARL7 2q37.1 243819_at GNG2 14q21 203753_at TCF4 18q21.1 235400_at FCRLM1 1q23.3 211474_s_at SERPINB6 6p25 226785_at ATP11C Xq27.1 215440_s_at BEXL1 Xq22.1–q22.3 209054_s_at WXSC1 4p16.3 227168_at FLJ25967 22p12.1 213355_at ST3GAL6 3q12.1 223218_s_at NFKBIZ 3p12–q12


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 508-508
Author(s):  
Shaji Kumar ◽  
Philip R. Greipp ◽  
Jessica Haug ◽  
Michael Kline ◽  
Wee Joo Chng ◽  
...  

Abstract Background: Thalidomide and dexamethasone combination has been shown to be an effective therapy for multiple myeloma (MM). In newly diagnosed patients with MM, the combination results in overall response rates of over 70% of patients. However, a considerable number of patients do not respond and will need to proceed to other therapies. The ability to identify patients who are unlikely to respond to particular therapies will allow tailoring of therapeutic approaches and in turn will reduce unnecessary toxicity and morbidity from lack of rapid disease control. With the availability of new technology such as gene expression profiling (GEP), this has become a possibility. We employed this approach to identify genes that can reliably predict lack of response to the thalidomide dexamethasone combination. Methods: Patient samples from the Eastern Co-operative Oncology Group clinical trial (E1A00), that compared thalidomide-dexamethasone combination with dexamethasone, and patient samples from the phase II Mayo Clinic study of thalidomide and dexamethasone, both for newly diagnosed MM, were used for this study. Thirty newly diagnosed patients who were evaluable for response were included in the analysis. GEP was performed using the Affymetrix U133A microarray platform as per manufacturer’s recommendation. The Affymetrix output (CEL files) was imported into Genespring 7.2 (Agilent Technologies) microarray analysis software, normalized across chips using GCRMA followed by per gene normalization to median. For the purposes of this study, responses were defined as reduction in the serum paraprotein (or the urinary M protein in the absence of a serum M protein) of >=50% (PR), 25 to 49% (MR), increase of >=50% (PD) and stable disease for the remaining. Results: Five of the 30 patients had no response to the thalidomide Dexamethasone therapy. Using the class prediction tool available in Genespring (Support Vector Machines), we identified 25 genes that reliable predicted non responders (PD, NC) from the responders (MR, PR, and CR). See table for a list of predictive genes with identified genes. Conclusion: Using a combination of two datasets we have identified a set of genes that can be used to reliably predict lack of response to thalidomide and dexamethasone in patients with newly diagnosed MM. We think that this represents a step towards creation of custom microarrays spotted with genes that are capable of predicting lack of response (or response) for the purpose of tailoring therapy to the patient. Gene Predictive strength hypothetical protein FLJ20719 1.655 Tubulin alpha 6 1.653 SEC3-like 1 (S. cerevisiae) 1.649 Ribosomal protein L18 1.546 Ribosomal protein L4 1.432 Tubulin alpha 6 1.409 cleavage stimulation factor 1.393 Tubulin, alpha, ubiquitous 1.393 CD99 antigen 1.38 hmel2 1.346 Leptin receptor 1.291 Integrin-linked kinaseSMC4 structural maintenance of chromosomes 4-like 1 1.269 Cornichon homolog 1.255 Williams-Beuren syndrome chromosome region 5 1.217 Ubiquitin specific protease 1 1.2 Sarcoma antigen NY-SAR-91 1.2


2021 ◽  
Vol 22 (21) ◽  
pp. 12070
Author(s):  
Anna Puła ◽  
Paweł Robak ◽  
Damian Mikulski ◽  
Tadeusz Robak

Multiple myeloma (MM) is a genetically complex disease that results from a multistep transformation of normal to malignant plasma cells in the bone marrow. However, the molecular mechanisms responsible for the initiation and heterogeneous evolution of MM remain largely unknown. A fundamental step needed to understand the oncogenesis of MM and its response to therapy is the identification of driver mutations. The introduction of gene expression profiling (GEP) in MM is an important step in elucidating the molecular heterogeneity of MM and its clinical relevance. Since some mutations in myeloma occur in non-coding regions, studies based on the analysis of mRNA provide more comprehensive information on the oncogenic pathways and mechanisms relevant to MM biology. In this review, we discuss the role of gene expression profiling in understanding the biology of multiple myeloma together with the clinical manifestation of the disease, as well as its impact on treatment decisions and future directions.


Author(s):  
Anna Puła ◽  
Paweł Robak ◽  
Damian Mikulski ◽  
Tadeusz Robak

Multiple myeloma (MM) is a genetically complex disease that results from a multistep transformation of normal to malignant plasma cells in the bone marrow. However, the molecular mechanisms responsible for the initiation and heterogeneous evolution of MM remain largely unknown. A fundamental step needed to understand the oncogenesis of MM and its response to therapy is the identification of driver mutations. The introduction of gene expression profiling (GEP) in MM was an important step in elucidating the molecular heterogeneity of MM and its clinical relevance. Since some mutations in myeloma occur in non-coding regions, studies based on the analysis of mRNA provide more comprehensive information on the oncogenic pathways and mechanisms relevant to MM biology. In this review, we discuss the role of gene expression profiling in understanding the biology of multiple myeloma together with the clinical manifestation of the disease, as well as its impact on treatment decisions and future directions.


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