By Esteban Braggio Ph.D., Rafael Fonseca M.D. (auth.), Nikhil C. Munshi, Kenneth C. Anderson (eds.)
Despite the advances in traditional, novel agent and excessive dose chemotherapy a number of myeloma (MM) is still incurable. so one can conquer resistance to present remedies and enhance sufferer final result, novel biologically-based therapy ways are being constructed. present translational study in MM targeting the advance of molecularly-based mixture treatments has nice promise to accomplish excessive frequency and sturdy responses within the majority of sufferers. significant advances are making this target attainable. First, contemporary advances in genomics and proteomics in MM have allowed for elevated knowing of illness pathogenesis, pointed out novel healing ambitions, allowed for molecular class, and supplied the medical purpose for combining certain treatments to extend tumor telephone cytotoxicity and abrogate drug resistance. moment, there's now an elevated knowing of ways adhesion of MM cells in bone marrow (BM) additional affects gene expression in MM cells, in addition to in BM stromal cells (BMSCs). due to those advances in oncogenomics at the one hand and elevated figuring out of the function of the BM within the pathogenesis of MM at the different, a brand new remedy paradigm focusing on the tumor mobilephone and its BM microenvironment to beat drug resistance and increase sufferer end result has now been constructed. Thalidomide, lenalidomide, and Bortezomib are 3 brokers which aim the tumor telephone in its microenvironment in either laboratory and animal types and that have quickly translated from the bench to the bedside. Ongoing efforts are utilizing oncogenomics and mobile signaling experiences to spot subsequent iteration of remedies in MM at the one hand, and to notify the layout of mixture trials at the different. This new paradigm for overcoming drug resistance and enhancing sufferer end result in MM has nice promise not just to alter the common historical past of MM, but in addition to function a version for specific therapeutics directed to enhance end result of sufferers with MM.
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Extra info for Advances in Biology and Therapy of Multiple Myeloma: Volume 1: Basic Science
Blood 85:2490–2497 7. Calasanz MJ, Cigudosa JC, Odero MD et al (1997) Cytogenetic analysis of 280 patients with multiple myeloma and related disorders: Primary breakpoints and clinical correlations. Genes Chromosomes Cancer 18:84–93 8. Smadja NV, Bastard C, Brigaudeau C, Leroux D, Fruchart C (2001) Hypodiploidy is a major prognostic factor in multiple myeloma. Blood 98:2229–2238 9. Drach J, Schuster J, Nowotny H et al (1995) Multiple myeloma: high incidence of chromosomal aneuploidy as detected by interphase ﬂuorescence in situ hybridization.
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Despite this heterogeneity, a few recurrent speciﬁc translocations have been described: the t(11;14)(q13;q32) in ~20% of the patients, the t(4;14) (p16;q32) in ~15% of the patients, and the t(14;16)(q32;q23) in ~5% of the patients. These more frequent translocations may actually deﬁne myeloma subtypes. The t(11;14)(q13;q32) is identical to that observed in mantle cell lymphomas. The breakpoints involve the IGH gene at 14q32, and the CCND1 gene at 11q13, encoding the cyclin D1 protein [34, 35]. One of the molecular consequences of the translocation is the upregulation of cyclin D1.