Dr. Jagannath on the Importance of Biology in Multiple Myeloma

Sundar Jagannath, MD, director of the Multiple Myeloma program and professor of medicine at the Tisch Cancer Institute, Mount Sinai Health System, discusses the importance of biology in multiple myeloma.

There is a misconception in oncology that giving a patient a particular chemotherapy will spur the development of resistance to the drug, explains Jagannath. However, greater insight into the biology of myeloma has fostered the understanding that patients may harbor dormant mutations prior to being exposed to the drug, meaning that the drug resistant clone already resides in the patient, states Jagannath.

When combinations of chemotherapy are given to a patient, the drugs are able to diminish most of the drug sensitive clone, but oftentimes small resistant clones are left behind. When those clones grow back, they cause relapse, Jagannath explains. Because of this, myeloma is a highly treatable but not necessarily curable disease. Although around 10% to 15% of patients can be cured, the majority will relapse.