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Myeloma describes a type of blood cancer that develops from cells in the bone marrow called plasma cells. Despite many scientific and medical advances, the cancerous condition is currently not curable. The main treatment goal is to get myeloma into remission and to keep it that way for as long as possible, and now a new gene test could help identify patients who could benefit from blood cancer medicine lenalidomide.
Researchers have found a new way to predict whether patients with myeloma could be aided by lenalidomide that can keep the disease from returning.
Certain patients saw their risk of cancer progress or dying cut by up to 40-fold when receiving the medication, the study published in the journal Blood suggested.
The gene test looks for genetic clues in cancer cells which could help pinpoint the patients who see little effect from the life-saving medicine. This could spare them side effects, such as exhaustion and infections.
The research team said these findings are “absolutely vital” and is calling for the test to be used to guide treatment for the 6,000 Britons diagnosed with myeloma each year.
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Many of these patients take lenalidomide for up to a decade to try to keep their disease under control. However, the blood cancer medicine is not helpful for certain people.
Dr Martin Kaiser, consultant haematologist and clinical scientist at London’s Institute of Cancer Research, said: “A common question they ask is, ‘Do I really have to keep taking this drug?’ and ‘How much is it actually helping me?’”
Worryingly, some studies have suggested that taking the drug for a long time may be associated with an increased risk of some cancers, including Hodgkin lymphoma, but more research is needed in this area.
The new gene test could help distinguish those who can genuinely benefit from lenalidomide and keep their cancer at bay.
The medicine blocks the development of abnormal cells, keeping the cancer in remission for about three years on average, compared to two years without treatment.
“But there’s huge variation – for some it’s a decade, for others a year,” said Professor Kaiser.
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Previously, there was no way of knowing who would not benefit from the drug.
But the new study from the Institute of Cancer Research and University of Leeds performed the test on 556 recently diagnosed myeloma patients and identified “super-responders”.
The test involves taking a sample of bone-marrow tissue via a needle in the back, under local anaesthetic, and looking for patterns in the cancer DNA.
Those with single-hit myeloma saw up to 40-fold reduced risk of cancer progression or death.
Patients with one of these “single-hit” genetic abnormalities lived for an average of 57.3 months longer before their disease progressed.
However, patients with a different “single-hit” genetic marker, known as gain(1q), seemed not to derive consistent benefit from lenalidomide, suggesting this group may be more complex than others.
Dr Kaiser added: “Those who may not be as likely to benefit may want to consider options such as clinical trials testing new drug combinations.”
The researchers believe it’s feasible to use the gene test to identify those who can benefit, because it is already widely available on the NHS.
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