Multiple myeloma begins in plasma cells, and affects many of the marrow-containing bones in the body, including arm, pelvis, and leg bones. The number of new cases of myeloma was 6.1 per 100,000 per year based on 2007-2011 cases, and myeloma is most frequently diagnosed among people aged 75-84.

The estimated incident of myeloma varies across the globe, with the highest rates being reported in the most economically developed regions of the world (e.g. Europe, North America, Australia/New Zealand) and the lowest rates in the least developed regions (e.g. parts of Africa, Asia and parts of Latin America).

Myeloma (C88 and C90), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

New combination therapy developed for multiple myeloma

Standard treatment for multiple myeloma encompasses chemotherapy, the administration of steroids and the targeted agent Velcade® (bortezomib). However, this form of blood cancer often develops resistance to therapies, which poses a major treatment challenge. Researchers at Virginia Commonwealth University Massey Cancer Center are reporting promising results from laboratory experiments testing a new combination therapy that could potentially overcome the resistance hurdle.

As researches show, multiple myeloma cells are able to survive by increasing the production of a protein known as Mcl-1. The protein regulates a number of processes that promote cell survival and has been implicated in resistance to anti-myeloma drugs that were initially effective. However, a team of researchers demonstrates that a novel drug combination both reduces Mcl-1 expression and disrupts its interactions with other proteins to effectively kill multiple myeloma cells.

The therapy combines a type of drug known as a Chk1 inhibitor with another called a MEK inhibitor. Chk1 inhibitors prevent cells from arresting in stages of the cell cycle that facilitate the repair of DNA damage, while MEK inhibitors prevent cells from activating a variety of proteins that regulate DNA repair processes while promoting the accumulation of pro-death proteins.

“By combining a Chk1 inhibitor with a MEK inhibitor, we have developed one of only a limited number of strategies shown to circumvent therapeutic resistance caused by high expressions of Mcl-1.” says Pei, instructor in the Department of Internal Medicine at the VCU School of Medicine.

Reference:

Circumvention of Mcl-1-Dependent Drug Resistance by Simultaneous Chk1 and MEK1/2 Inhibition in Human Multiple Myeloma Cells. PLoS ONE, 2014; 9 (3): e89064

Advances in genomics have brought convenience of genetically stratified cancer patients which would affect the tailored therapy. Additionally, genomics in the combination of molecular biology, engineering, and bioinformatics has revolutionized understanding of predisposed genes inducing the occurrence of cancer development , as well as of potential treatment responses.

Genomics has remarkably influenced cancer research. Investigating the molecular characteristics in terms of gene expression, structural shifts of the genome , and mutations, as well as their influence in metastatic behavior and therapeutic responses will revolutionize cancer treatment.

Key characteristics of individual cancers are hoped to be identified and then support to establish tailored therapeutics. Thus investigators have been attempting to find out sets of genes associated with cancer and novel drug development targets. For instance, Roche’s antibody MPDL3280A (RG7446) in clinical development acts against an immune checkpoint blockade expressed in tumors.

Cancer Diagnostics for treatment 

Genetic tests have already changed medical practice. Patient’s genetic information obtained from genetic tests is often employed for differentiating their vital genotypes, and physicians thereby offer optimal medical decisions, practices and drugs. Decipher Prostate Cancer Classifier from GenomeDx, analyzing the activity of 22 genetic markers expressed in the prostate cancer, classifies the patient’s tumor independently of Prostate-Specific Antigen (PSA) rise. Scientists developed genome-wide search algorithms of more than a million markers, and discovered  these 22 markers related to aggressive disease.

Myriad’s Prolaris is a risk-stratification tool for patients with prostate cancer. Designed to measure the aggressiveness of a patient’s cancers to better predict an individual’s relative risk of disease progression within ten years, it can enable physicians to better define a treatment/monitoring strategy for their patients.

Oncogenic mutations of driver Genes

Adding to the complexity of data is the discovery of “driver” genes and their role in cancer biology. Elli Papaemmunuil and colleague recently described their analysis of oncogenic mutations in large, well-characterized patient cohorts of myelodysplastic syndromes (MDS), characterized by dysplasia, ineffective hematopoiesis, and a variable risk of progression to acute myeloid leukemia.

Using previously identified mutations in genes implicated in RNA splicing, DNA modification, chromatin regulation, and cell signaling, the investigators sequenced 111 genes across 738 patients with MDS or closely related neoplasms to explore the role of acquired mutations in MDS biology and clinical phenotype.

The scientists reported that 78% of patients had one or more oncogenic mutations and that they could identify complex patterns of pairwise association between genes, indicative of epistatic interactions involving components of the spliceosome machinery and epigenetic modifiers.

References:

1. Anti-programmed death-1 and anti-programmed death-ligand 1 antibodies in cancer therapy. Expert Opin Biol Ther. 2013 Jun;13(6):847-61.

2. Genetic testing comes of age in prostate cancer. Trends in Urology & Men’s Health.2014;5( 2): 9–13,

3. Academic medical centers: ripe for rapid-learning personalized health care. Sci Transl Med. 2011 Sep 21;3(101):101cm27.

The latest statistics show that half of all people diagnosed with cancer in England and Wales today will survive for at least 10 years, which experts have hailed as a “tipping point” in the global fight against cancer. The news was widely covered in the media, such as Telegraph, the Independent, and Guardian.

Survival rates on variant type of cancers

Cancer Research UK says that by the 2030s, it is realistic to expect that as many as three in every four cancer patients would survive 10 years after diagnosis. By contrast, the 10-year survival rate was as low as one in four In the 1970s.

Survival rates for nearly all cancers are increasing every year. In the past 40 years, the 10-year survival rate for testicular cancer has increased from 69 to 98 percent ; for malignant melanoma from 46 to 89 per cent; and for prostate cancer from 25 to 84 percent, according to research carried out by a team at the London School of Hygiene and Tropical Medicine.

But it’s not all good news. Just one percent of pancreatic cancer patients and five per cent of lung cancer patients diagnosed today are expected to survive 10 years. Cancer Research UK has worked to increase research into these cancers but change has been slower than hoped.

Scholars’ views

Dr Harpal Kumar as the charity’s chief executive says “the past 20 years have seen an explosion in our understanding of the disease. In 20 years’ time, we want three quarters of the people who hear those words: ‘you’ve got cancer’, to also hear the words: ‘but don’t worry you’ll be fine’. We firmly believe that’s achievable.”

Paula Young as Cancer Research UK’s spokeswoman for East Anglia says“Every year, tens of thousands more people are surviving cancer a decade after diagnosis, showing that we’re gradually reversing the tide on this devastating disease. This is thanks to the work of our scientists and doctors, but none of it would be possible without the generosity of the public, whose donations we rely on to fund all our research.”