The chromosome 1q21 story (1/10):
-Having extra copies of generally odd num. chromosomes constituents hyperdiploidy #mmsm , recognized as ‘HY’ in GEP based molecular classification.
-Having 3 copies is called ‘gain 1q21’
-Having >=4 copies is called ‘amplification of 1q21’.
-Having extra copies of generally odd num. chromosomes constituents hyperdiploidy #mmsm , recognized as ‘HY’ in GEP based molecular classification.
-Having 3 copies is called ‘gain 1q21’
-Having >=4 copies is called ‘amplification of 1q21’.
The chromosome 1q21 story (2/10):
-Herve Avet-Louiseau identifies 1q21 ‘enhancement’ in human MM cell lines, primary MM cells and plasma cell leukemia (PMID: 9172003), Shaughnessy et al corroborate (PMID: 15472896).
- Gain/Amp ch. 1q21 first recognized as poor prognostic markers
-Herve Avet-Louiseau identifies 1q21 ‘enhancement’ in human MM cell lines, primary MM cells and plasma cell leukemia (PMID: 9172003), Shaughnessy et al corroborate (PMID: 15472896).
- Gain/Amp ch. 1q21 first recognized as poor prognostic markers
The chromosome 1q21 story (3/10):
...in MM by Arkansas group in mid-2000s (PMID: 16188652, PMID: 16705089)
- Corroborated by other groups (PMID: 16995883, PMID: 17024118, PMID: 20537706, PMID: 21523726) in the context of pre-novel and doublet novel induction/transplant era.
...in MM by Arkansas group in mid-2000s (PMID: 16188652, PMID: 16705089)
- Corroborated by other groups (PMID: 16995883, PMID: 17024118, PMID: 20537706, PMID: 21523726) in the context of pre-novel and doublet novel induction/transplant era.
The chromosome 1q21 story (4/10):
-Gain/amp 1q21 signifies bortezomib resistance.
-Shaughnessy et al showed that gain/amp 1q21 resulting in over-expression of proteasome genes, 3 copies = bortezomib intermediate sensitive, >=4 copies are bortezomib resistant (PMID: 21628408).
-Gain/amp 1q21 signifies bortezomib resistance.
-Shaughnessy et al showed that gain/amp 1q21 resulting in over-expression of proteasome genes, 3 copies = bortezomib intermediate sensitive, >=4 copies are bortezomib resistant (PMID: 21628408).
The chromosome 1q21 story (5/10):
-Others later have shown the same observation of inferior outcomes with gain/amp 1q21 treated with bortezomib based induction (PMID: 24213147, PMID: 24616227, PMID: 25779478, PMID: 27638366, PMID: 29967379, PMID: 31881283).
-Others later have shown the same observation of inferior outcomes with gain/amp 1q21 treated with bortezomib based induction (PMID: 24213147, PMID: 24616227, PMID: 25779478, PMID: 27638366, PMID: 29967379, PMID: 31881283).
The chromosome 1q21 story (6/10):
The S1211 is the only prospective randomized trial, albeit phase 2, in high risk disease that in included 1q21 abnormalities (ascopubs.org/doi/abs/10.120…), making up 47% of the patients.
The S1211 is the only prospective randomized trial, albeit phase 2, in high risk disease that in included 1q21 abnormalities (ascopubs.org/doi/abs/10.120…), making up 47% of the patients.
The chromosome 1q21 story (7/10):
- S1211 median PFS on the RVd induction/RVd maintenance arm (control arm) = 34 months.
- I doubt there will ever be a head to head trial comparing RVd to KRd in high risk, but there will be KRd +/- mAb trials in MM that includes gain/amp1q21
- S1211 median PFS on the RVd induction/RVd maintenance arm (control arm) = 34 months.
- I doubt there will ever be a head to head trial comparing RVd to KRd in high risk, but there will be KRd +/- mAb trials in MM that includes gain/amp1q21
The chromosome 1q21 story (8/10):
-I am an ardent Barlogie disciple, he taught me to use the best available evidence with patient’s disease biology to treat each individual patient.
- Myeloma care would be very simple if it’s all vanilla - but it ain’t.
-I am an ardent Barlogie disciple, he taught me to use the best available evidence with patient’s disease biology to treat each individual patient.
- Myeloma care would be very simple if it’s all vanilla - but it ain’t.
The chromosome 1q21 story (9/10):
-The best available evidence may be imperfect.
- Any treatment decision has to be an informed, individualized, shared decision with your patient.
- In absence of >PR, I would discuss changing Bor with Car during induction for amp/gain 1q21 pts.
-The best available evidence may be imperfect.
- Any treatment decision has to be an informed, individualized, shared decision with your patient.
- In absence of >PR, I would discuss changing Bor with Car during induction for amp/gain 1q21 pts.
The chromosome 1q21 story (10/10):
I would welcome comments/discussion from #mmsm peeps #highriskMMtweet @SagarLonialMD @VincentRK @Rfonsi1 @ninashah33 @TomBmt133 @Myeloma_Doc @myelomaMD @mvmateos @kaufman_MMdoc @EagleMyeloma @NoopurRajeMD @jmikhaelmd @theMMRF @IMFmyeloma @SWOG
I would welcome comments/discussion from #mmsm peeps #highriskMMtweet @SagarLonialMD @VincentRK @Rfonsi1 @ninashah33 @TomBmt133 @Myeloma_Doc @myelomaMD @mvmateos @kaufman_MMdoc @EagleMyeloma @NoopurRajeMD @jmikhaelmd @theMMRF @IMFmyeloma @SWOG
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