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What Experts Are Learning About the Hereditary Risk of Myeloma

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What Experts Are Learning About the Hereditary Risk of Myeloma from Patient Empowerment Network on Vimeo.

Myeloma experts Dr. Irene Ghobrial and Dr. Betsy O’Donnell share research updates on predicting the risk of developing myeloma, both from inherited genetics as well as environmental factors.

Dr. Irene Ghobrial is Director of the Clinical Investigator Research Program at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School. Learn more about Dr. Ghobrial.

Dr. Betsy O’Donnell is Assistant Professor of Medicine at the Dana-Farber Cancer Institute specializing in Plasma Cell Disorders.

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Katherine Banwell:

Is there any research on predicting hereditary risk of myeloma? 

Dr. Irene Ghobrial:

Yes, so part of the PROMISE study is trying to understand what is the risk of developing myeloma? So, we’re recruiting people who are either African American, because they have a three times higher chance of developing myeloma compared to the white population, as well as people who have a first degree family member with a plasma cell disorder. 

Or even any blood cancer because now we see that CLL and lymphoma and myeloma can actually come together. And we’re now doing something called whole genome sequencing of all of the DNA that you inherit from Mom or Dad called the germ line. Basically, we try to see did you inherit the gene from Mom or Dad that increases your risk to myeloma? 

Now, it’s not as high as something like BRCA1 mutation or 2 mutation, where if you have that, you’re high, high chance of developing breast cancer or ovarian cancer and so on. We probably have several factors that need to be put together. You inherit something and then the environment adds something, and then as we get older, we get the hit. 

Or you inherit something that changes your immune system, and that allows the plasma cells to start proliferating faster because they are reacting as an immune cell, and that allows the hit of myeloma to happen. And we’re working on that, and we would really encourage everyone who has a relative with myeloma, sign up on PROMISE study. 

Because that’s how we can get the answer. That’s how we can say it’s not because you are an African American or you’re white. It’s not because you have a first-degree family member or not. It’s because of this gene. So, taking away race, taking away all of those factors, taking away age and trying to go back to the biology. Is it a certain gene, is it the certain immune cell that makes us go to that risk? 

And then Dr. O’Donnell is really taking it to the next level. Now what is in the macro environment? So, we talked about what we inherit, but it’s like nurture and nature, right? So, nature is the genetics and then nurture, what do we eat? What do we change? Obesity, health, all of those things change our inflammation level and change our ability to basically prevent those myeloma cells from starting or from continuing to progress. And she can potentially talk about her work on microbiome, on the tiny bacteria that are in our body from what we eat. So, maybe, Betsy? 

Katherine Banwell:


Dr. Betsy O’Donnell:

Absolutely. Yes, so one of the things that particularly interests me is the effect of lifestyle on our risk of getting cancer. 

And specifically within plasma cell disorders, and I think there have been other cancers, breast cancer and colon cancer, where they’re a couple steps ahead of us just in understanding the influence of things like obesity and the gut microbiome. So, the specific bacteria that are within your intestinal tract. It makes a lot of sense in colon cancer, but we think that that’s not limited to diseases like that. We actually think that these microbiomes, which are influenced by the foods that you eat, may have a relationship with your immune system. And remember, myeloma is a cancer of the immune system. 

So, we’re all working together on our team here on a very scientific level to understand lifestyle influences and how they may cause or potentiate multiple myeloma. And so we’re excited to kind of bring this piece together. When you think about the spectrum of plasma cell disorders, not everybody goes on to myeloma, but a lot of people sit in these early precursor diseases, MGUS and early smoldering.  

And so are there things that people can do for themselves that might influence their gut microbiome, or if it’s the amount of body fat that we have that’s very involved in cell signaling? Can we modify those things, exercise more potentially, that will decrease our body inflammation levels or alter those pathways that have been set in process that, by altering them, may decrease the risk of going on to more advanced plasma cell disorders? 

Katherine Banwell:

That’s such great information.  

November 2017 Notable News

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All cancer, on a very basic level, is the same. It is the uncontrolled growth of cells. However, each type of cancer varies greatly and that is why early detection and individualized treatment is so important for patient health and survival. Fortunately, research breakthroughs come along every day that help pave the way to successful, individualized treatment.

A breakthrough in breast cancer research has come from an unlikely place, reports al.com. For his winning science fair project, high school senior Kenneth Jiao researched breast cancer and made a discovery that may help stop the spread of the disease to other organs. Through his research, Kenneth discovered that the CHD7 gene and it’s molecular processes may prevent metastasis. Kenneth’s project was inspired by a breast cancer scare his mother had a couple of years ago. His mother’s tumor turned out to be benign, but the worry and fear Kenneth felt during that time motivated him to look for ways to prevent the disease. Kenneth earned a $3,000 scholarship for his win and is moving on to the final round of competition in Washington, D.C. where he could end up winning $100,000 in scholarship money. You can learn more about Kenneth and his science fair experience here.

Researchers may have found an easier way to find successful, individualized cancer treatment by experimenting on tiny replicas of unhealthy cancer cells called tumoroids, reports economist.com. The tumoroids, which were developed from the cells of eight liver cancer patients, are unique in that they contain only cancerous cells. Traditionally cultured cells are often mixed with healthy cells, which can affect the results of the genetic analysis. Along with gaining a better understanding of the cancerous cells, the research team is using the tumoroids to test anti-cancer drugs. The hope is that, eventually, replicas will be made of individual patients’ cells which will then be examined and tested to determine personalized treatment options. Find more information about the tumoroid research, here.

About 70 percent of women diagnosed with the most frequently occurring type of ovarian cancer are diagnosed with an advanced stage of the disease, but according to cancer.gov new research may help to change that. A new study reveals that the most common ovarian cancer, known as HGSOC, may begin as lesions in the fallopian tubes several years before the start of ovarian cancer, which means there is a potential for early detection. The new study supports and expands on a study done ten years ago that identified fallopian tube lesions in women with the BRCA1 or BRCA2 mutations. The evidence now shows that HGSOC originates from the fallopian tube lesions whether the BRCA mutations are present or not. Not all ovarian cancers originate from the fallopian tube lesions and more research needs to be done, but there is hope for the possibility of early diagnosis and prevention. More details about the study and further research can be found here.

There are thousands of species of bacteria that live in and on our bodies and the ones living in our stomach, our stomach microbiome, may be a major factor in the risk of tumor development, according to new research reported by worldwidecancerresearch.org. The study shows a link between the microbial diversity of the stomach and varying health conditions — some cancerous and some not — and while many factors are involved in gastric cancer development, the study shows that the stomach microbiome may be one of those factors. Understanding and being able to change stomach bacteria may one day lead to the prevention or treatment of stomach cancer. Learn more about the exciting microbiome discovery here.

Check back next month for more exciting breakthroughs and in the meantime, keep up with the latest at PEN here.