Multiple Myeloma (MM) is an incurable cancer of the plasma cells. Almost all patients diagnosed with MM have had one of two precursor conditions called monoclonal gammopathy of undetermined significance (MGUS) or smoldering multiple myeloma (SMM) before their disease has caused damage to organs such as bone lesions, fractures, and kidney failure. However, most patients are not diagnosed with these precursor conditions because there is no routine screening for them.
MGUS is a very common condition that affects 3 percent of the general population aged 50 years or older and increases with age. It is 3 times more common in African-Americans and presents at an even younger age in this population. Unlike expensive and controversial screening studies for other cancers, MGUS can be screened for by a simple blood test. However, this has not been the practice to date.
The hypothesis of this project is that early detection of MGUS/SMM in a high-risk population, along with a good understanding of the molecular and immune factors that lead to disease progression, will lead to effective strategies that intercept disease progression and improve survival.
The Dream Team is conducting a screening study of individuals over the age of 45, who are at high risk for having MGUS or SMM, such as African-Americans and individuals who have a first-degree relative that has been diagnosed with a plasma cell disorder: the PROMISE study
The Dream Team seeks to define biological characteristics (such as inherited mutations, acquired mutations, and immune factors) that will help to identify which patients will benefit from particular therapies. The Dream Team will also identify lifestyle and demographic factors that contribute to disease progression, such as obesity and race.
The Dream Team also aims to develop new therapeutics that can be used to prevent MM from progressing, including novel technologies of nanoparticles for better imaging of early disease and the first personalized neoantigen vaccine study for the population of patients screened.
Joseph R. Mikhael, MD, professor of medicine, Mayo Clinic Arizona
Jeremiah A. Johnson, PhD, assistant professor, Massachusetts Institute of Technology
Gad Getz, PhD, Broad Institute
Lorelei Ann Mucci, MPH, ScD, associate professor of epidemiology, Harvard T.H. Chan School of Public Health
Timothy Rebbeck, PhD, professor of epidemiology, DFCI
Viktor A. Adalsteinsson, PhD, research scientist, Broad Institute